Remote Pharmacy Audit Analyst – Travel Up to 75%

NHSHP; Irvine, Northern (CA, KY); Hybrid; USD 50,000 - 89,000; Full time

Job summary

UnitedHealth Group seeks a Pharmacy Auditor/Investigator to perform pre-audit work, onsite and desktop audits, and travel as needed.

Requirements include a Pharmacy Technician License, PTCB certification, and 2+ years in pharmacy audit or health insurance environments; strong MS Office skills are expected.

Telecommuting is allowed from anywhere in the U.S., with up to 75% travel. Salary is $49,700–$88,800 annually plus benefits.

Qualifications

• Current and unrestricted Pharmacy Technician License for the state of residence.
• Must be currently certified by the PTCB (Pharmacy Technician Certification Board).
• 2+ years of experience in pharmacy audit, PBM, healthcare investigations, or health insurance.
• 2+ years of experience processing pharmacy or medical claims.
• 2+ years of independent researching/investigations; analytical and self-motivated.
• Advanced proficiency with Microsoft Office (Word, Excel).
• Home location within 45 miles of International Airport.
• Ability to work remotely AND travel up to 75% per year.

Responsibilities

• Complete pre-audit work including travel planning and desk audits.
• Perform onsite and desktop pharmacy network audits to identify discrepant claims.
• Assess premises, regulatory compliance, and record completeness.
• Gather and review documentation up to but not including prescription hardcopies.
• Facilitate questions from pharmacy network providers on a rotation basis.
• Report findings to pharmacy network providers.
• Review and assess audit quality and accuracy (QC).

Skills

Analytical skills

Independent investigator

Research skills

MS Office proficiency

Education

Pharmacy Technician License

PTCB Certification

Bachelor's Degree

Tools

RxClaim

Job description

UnitedHealth Group seeks a Pharmacy Auditor/Investigator to perform pre-audit work, onsite and desktop audits, and travel as needed.

Requirements include a Pharmacy Technician License, PTCB certification, and 2+ years in pharmacy audit or health insurance environments; strong MS Office skills are expected.

Telecommuting is allowed from anywhere in the U.S., with up to 75% travel. Salary is $49,700–$88,800 annually plus benefits.