Pharmacist - Management & Claims Analysis (A break from retail!)

UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.

Ingenix, a UnitedHealth Group company, is one of the largest health care information and research companies in the industry. No one competitor offers the same breadth of products and services as Ingenix. In fact, our competitors strive to copy what we have done. We offer the most comprehensive set of data, technology and analytic capabilities. The power of our products and services help customers leverage information assets, enhance clinical and financial insight, increase the quality of health care delivery and administration and improve cost management.





This is highly visible position in a Fortune 100 Company. It's not for everybody. But if you're a solution-focused Pharmacist, and you have the analytical skills to identify fraudulent pharmacy claims in a fast-paced environment, we urge you to bring your expertise to this rewarding leadership role today.





We're prepared to offer you unmatched benefits, a wealth of corporate resources, and the chance to carve out your own capacity while overseeing a group of talented professionals.





Primary responsibilities include:


Managing a group of Oracle database programmers and project managers
Conducting performance reviews of staff
Analyzing healthcare claims data to identify overpayments related to fraud, waste, or inappropriate utilization of healthcare services
Researching and interpreting healthcare claims payment policy to identity potential revenue recovery opportunities
Directing activities of systems developers to facilitate movement of recovery opportunities from concept to implementation
Defining data mining strategies and algorithms
Documenting and presenting data analysis results to internal associates and external clients
Developing and maintaining comprehensive documentation of data analysis methodologies

Job Requirements:

Only licensed Pharmacists will be considered for this position. Significant pharmacy experience in a retail setting is required, as is extensive management or project management experience. A solid background with healthcare claims processing and data analytics is essential. MS Office proficiency is a must. Experience with health insurance benefits and policies is preferred. A background working with quality assurance programs is desired, while database expertise and analysis is strong asset.





UnitedHealth Group offers a full range of comprehensive benefits, including medical, dental and vision, as well as a matching 401k and an employee stock purchase plan.





If you are interested in growing professionally within an innovative, highly respected organization, we invite you to explore this excellent growth opportunity!



Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V.