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Job Details


UnitedHealth Group

Administrative Technician - TennCare TN Medicaid RFP CSB (112171147)

Clerical and Administrative

Administrative Assistant

Yearly

No

Nashville, Tennessee, United States

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm)

Primary Responsibilities:

  • Responsible for monitoring and managing appeals tasks in TennCare specific Tracking system
  • Process lock-in appeal requests
  • Serve as the primary point of contact for business partners regarding Direct Member Reimbursement (DMR) and the processing of DMR request
  • Accurately track and report claim status of DMR claims
  • Run and analyze daily PA reports for DCS clients
  • Engage with appropriate PBM business staff in reviewing business scenarios for Direct member reimbursement (DMR)
  • Collaborate with other business functional groups
  • Assist in CoverRx program application management
  • Monitoring of designated correspondence and medical records
  • Create/mailing specific correspondence to members on behalf of the client
  • Works closely with Clinical Account Manager and Account Director to perform any other assigned tasks

What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

  • Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
  • Medical Plan options along with participation in a Health Spending Account or a Health Saving account
  • Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
  • 401(k) Savings Plan, Employee Stock Purchase Plan
  • Education Reimbursement
  • Employee Discounts
  • Employee Assistance Program
  • Employee Referral Bonus Program
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
  • More information can be downloaded at: http://uhg.hr/uhgbenefits

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 (or higher)
  • Certified Pharmacy Technician (CPhT)
  • 4+ years of experience analyzing and solving customer problems in an office setting environment using the telephone, computer, and face - to - face discussions as the primary instruments to perform job duties
  • Proficient with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
  • Proficient in Microsoft Excel
  • Ability to work on site at the State of Tennessee HCFA office in Nashville, TN
  • Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

Preferred Qualifications:

  • Undergraduate degree
  • Fee For Service Medicaid or Medicaid Managed Care experience
  • PBM experience
  • Client facing or account management support experience

Soft Skills:

  • Ability to multi - task, this includes ability to understand multiple products and multiple levels of benefits within each product
  • Analytical skills

Physical Requirements and Work Environment:

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

To protect the health and safety of our workforce, patients, and communities we serve, UnitedHealth Group and its affiliate companies now require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles 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 Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)


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.


Keywords: UnitedHealth Group, Administrative Technician, Nashville, TN, Optum, #RPO, #RED

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