UnitedHealth Group Business Operations Specialist - Cebu City, Cebu in Cebu City, Philippines
We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives.
Yes, we share a mission that inspires.
We need your organizational talents and business discipline to help fuel ours.
It's the opportunity to do your life’s best work.(sm) This Business Operations Specialist position is required to handle increased workload associated with Prior Authorization system setup.
The Prior Authorization system setup includes the loading of letters, updating of tables, loading clinical guidelines, and updating automated decision trees.
This role is vital since without it we will risk incomplete guidelines, incomplete or incorrect approval and denial letters loaded for each client for each migration resulting in increased cost to client and decreased member satisfaction. Primary Responsibilities: Would be responsible for developing tools using G10VBA, Access and excel macros Tools Developed are used for reporting & automating of Existing applications Analyze existing tools to identify opportunities of automations Ensures that informational needs of our client and internal customers are met by designing and creating tools, which will help in speed up processing with 100% accuracy Attend and provide proactive input at all relevant meetings with key client stakeholders Analyzes existing reports and redesigns them for: Ease of use Elimination of duplication Consolidation into more comprehensive reports Interacts with other departments to determine reporting needs and provides expectations for completion Designs and creates ad hoc reports to meet client needs Supports the goals of the department by performing ad hoc duties as assigned by the director. Collaborate regarding report design and system development Share outcomes information, provide feedback regarding data quality needs, seek review, classification systems, and participate in system design meeting Collaborate regarding benchmarking, data modeling of new reports, survey development, and development of ROI formulas Develop innovative reports for new products Required Qualifications: Research experience in AS400/RxClaim Expert to Proficient in Excel, Access and VBA Area of expertise has to be MS Word; Visual Basic with basic knowledge of SQL Basic knowledge in UAT Should be an expert in reading, recording, writing Macros in Excel VBA/ Access Strong writing and documentation skills Proactive communication (both verbal & written for business communication) Extremely well organized, detailed & multi-task oriented Ability to transform data into organized insightful information Able to meet tight timeline Organizational skills Creativity Open to work in Night shift Preferred Qualifications: Bachelor's Degree in Business with Computer Science exposure, or equivalent experience Pharmacy Claims experience Pharmacy Help Desk or RCR knowledge Well-rounded business knowledge including standard prior authorization process Well-rounded knowledge of the Pega or Pega Rules Process Commander (PRPC) application Knowledge of Center for Medicare Services (CMS) Regulations Knowledge of Prior Authorization Case turnaround times (TAT) Careers with Optum.
Here's the idea.
We built an entire organization around one giant objective; make health care work better for everyone.
So when it comes to how we use the world’s large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve.
Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential.
For you, that means working on high performance teams against sophisticated challenges that matter.
Optum, incredible ideas in one incredible company and a singular opportunity to do your life’s best work.(sm) Diversity creates a healthier atmosphere: Optum is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Optum is a drug-free workplace.
© 2017 Optum Global Solutions (Philippines) Inc.
All rights reserved. Job Keywords: Business Operations Specialist, Business Operations, AS400/RxClaim, Excel, Access, VBA, Visual Basic for Applications, MS Word, Visual Basic, SQL, Structured Query Language, UAT, User Acceptance Testing, Cebu City, Cebu 01a66b39-cf2d-4335-8aac-2be0015623bd
Business Operations Specialist - Cebu City, Cebu Philippines-Cebu City 721199