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Job Details

UnitedHealth Group

Business Process Consultant - Telecommute (109523832)

Business Development




Irvine, California, United States

Optum is a company that's on the rise. We're expanding in multiple directions, across borders and, most of all, in the way we think. Here, innovation isn't about another gadget, it's about transforming the health care industry. Ready to make a difference? Make yourself at home with us and start doing your life's best work.(sm)

Welcome to one of the toughest and most fulfilling ways to help people, including you, live healthier lives. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement.

Flexible, friendly, fast on your feet, that's a great start. Accurate, accountable, self-directed, these traits can take you places. Our Audit, Recovery & Safety (ARS) Team is a focal point of OptumRx overseeing client and pharmacy claim auditing and safety regulations for Optum Rx ensuring exceptional service behaviors, processes, and practices are met for our clients and members. Supporting this effort is complex, detailed work. It's fast paced and challenging. It's a job that calls on you to be thoughtful, resourceful, team-driven and customer-focused. To put it mildly, there is never a dull moment.
The Business Process Consultant is responsible for supporting the Pharmacy Audit Recovery Platform (PARP) Application Team (PARP A-Team) within ARS who maintains machine learning (ML)/artificial intelligence (AI) data analytics and reporting system capabilities. Position will act as the application subject matter expert (SME) and technical lead for system support for the PARP application focused on ML models for pharmacy claim data and PEGA workflows. Additional responsibilities will include, but are not limited to, issue triage, user assistance, UAT testing, system testing, reporting, defect management, and stakeholder coordination. The Business Process Consultant will work with business leaders, subject matter experts, and IT, as needed acting as a liaison to ensure the functionality of the PARP system remains viable which is critical for audit performance and set revenue targets for pharmacy network audits.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Leads ML/AL modeling and enhancement functionality for PARP
  • Manages defects
  • Provides system support
  • Analyses large data sets
  • Dissects coding for issues, errors, and or enhancements and retain logic and workflows
  • Provides issue triage and user assistance
  • Runs test validations and provide test support
  • Provides reporting
  • Identifies new ML opportunities
  • Documents key processes
  • Develops communications
  • Supports planning and tracking of key deliverables
  • Provides coordinated support between business and IT
  • Creates lessons learned and presents them to team and/or stakeholders as needed
  • Analyzes pharmacy claim data information and utilizes it reduce errors and improve process performance

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:

  • Bachelor’s degree and or equivalent years of experience
  • 3+ years business analysts experience, preferably highly skilled in reporting and/or testing

Preferred Qualifications:

  • Experience with ML modeling
  • Intermediate level experience with SQL (select data, joins against more than one table, etc.) and experience managing large sets of data
  • Advanced understanding of ML, claim selection, and underlying algorithms and data transformation
  • Familiar with pharmacy and medical claim data
  • Ability to own and retrain ML models
  • Ability to provide system support by analysis, research, and reporting
  • Advanced communication skills and ability to work across both internal and external teams/departments
  • Advanced individual contributor who can take guidance and or requirements with little to no direction
  • Ability to change gears in a high paced, high functional team
  • Self-directed

Physical Requirements and Work Environment:

  • Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse

Take the next step, online at:

Optum Rx 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.

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 healthcare 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. Join us and start doing your life’s best work.

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment.

Careers with OptumRx. We're one of the largest and most innovative pharmacy benefits managers in the US, serving more than 12 million people nationwide. Here you’ll fill far more than prescriptions. As a member of one of our pharmacy teams, you’re empowered to be your best and do whatever it takes to help each customer. You'll find unrivaled support and training as well as a wealth of growth and development opportunities driven by your performance and limited only by your imagination. Join us. There's no better place to help people live healthier lives while doing your life's best work.(sm)

Colorado, Connecticut or Nevada Residents Only: The salary range for Colorado residents is $82,100 to $146,900. The salary range for Connecticut / Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action 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.

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