Business Process Consultant

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week.

At UnitedHealthcare, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together

About UnitedHealthcare Medicare & Retirement

As the largest U.S. business dedicated to serving the rapidly expanding Boomer population, we are committed to improving quality of life for more than 9 million members. Joining our team means contributing to meaningful, long term solutions that strengthen the health care system.

Position Overview

The Business Process Consultant is responsible for overseeing key pharmacy business operations, ensuring regulatory compliance, and driving performance across delegated functions. The role requires strategic thinking, strong problem solving abilities, and the capacity to present insights and recommendations to leadership.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

We offer on-the-job training. The hours of the training will be based on schedule or will be discussed on your first day of employment.

Primary Responsibilities:

• Provide oversight for Government Programs Coverage Determinations, Direct Member Reimbursement (manual claims), and Pharmacy Help Desk operations delegated to the Pharmacy Benefit Manager (OptumRx) for Part D and Individual & Family Plan products
• Lead operational implementation for new market expansion
• Develop and execute oversight programs to ensure regulatory and contractual compliance
• Monitor business performance and communicate results, risks, and opportunities to leadership
• Identify and lead initiatives to improve operational performance, reduce administrative costs, enhance member and provider experience, and support government audits
• Build effective working relationships within UHC Government Programs Pharmacy and with PBM partners

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED
• Must be 18 years of age OR older
• 5+ years of experience in pharmacy business operations
• 5+ years of experience in business analysis
• Experience leading or owning projects, programs, or implementations
• Ability to absorb information, make decisions, and solve complex problems
• Communication and presentation skills
• Intermediate or advanced proficiency with Microsoft Excel and Microsoft PowerPoint
• Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00 am - 5:00 pm CST. It may be necessary, given the business need, to work occasional overtime.

Preferred Qualifications:

• Experience with pharmacy authorizations
• Experience presenting data and recommendations to senior leadership
• Experience working with a Pharmacy Benefit Manager (PBM)

Telecommuting Requirements:

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 - $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.