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Job Field: Legal Jobs
Location: San Diego, CA
Salary: $Not stated

JOB SUMMARY:

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<tr><td valign="top" width="450"><b>Title: Bussiness Operations Specialist - San Diego, CALocation: US-CA-San DiegoJob Number:_504866Position Description: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.Core Competencies:* Strong writing and documentation skills* Organizational skills* Creativity* Ability to work with other remotely, collaborate and provide feedback* Ability to multi task and redirect work quickly due to client demands* Knowledge and Experience with specialty pharmacy business is preferredQualifications:Requirements:* High School Diploma/GED is the minimum requirement* Experience working independently within a research oriented role* Must have basic Microsoft Excel skills: Creating spreadsheets and inputting data* Must have basic Microsoft Word skills: DocumentingAssets:* Well-rounded business knowledge including specialty prior authorization process * Well-rounded knowledge of the Pega or Pega Rules Process Commander (PRPC) application* Knowledge of Center for Medicare Services (CMS) Regulations (Part D process)* Knowledge of Prior Authorization Case turnaround times (TAT)* Research experience in AS400/RxClaim - (Prior Authorization process)OptumRxis part of the family of companies that makeUnitedHealth Groupone of the leaders across most major segments of the US health care system.If you''re ready to talk about groundbreaking interactions, let''s talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let''s talk about smart, motivated teams. Let''s talk about more effective and affordable health care solutions. This is caring. This is great chemistry. This is the way to make a difference. We''re doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance. OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do. In the largest and most personal sense, your impact can be greater than even you thought at OptumRx.Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/VUnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.Job: Bus Opns General Support

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