Credentialing/ Licensing Specialist - San Juan, PR (107326202)
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)
You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that definitely can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.
The Licensing Specialist, in charge of secondary filings, is responsible for running reports from BLH and analyzing these Secondary Filings using a Tracker to ensure all are accounted for. The Secondary Filings Tracker includes license expiration dates, status of filing, method of license delivery to state, and follow up notes.
This is a critical function in maintaining Medicaid provider enrollments as states can deactivate the enrollment if required documents are not received and their records updated timely. There is significant follow up involved to ensure the states have updated their records. This includes making phone calls to state Medicaid agencies and/or following up through email.
- In order to maintain Medicaid provider enrollments for our owned pharmacies, the Government Programs licensing team is required to supply current Board of Pharmacy licenses, city/business licenses, and DEA. This is done in a variety of ways, ie:
- Logging onto a portal and updating the expiration date and uploading the current license(s)
- Faxing license to the state
- Emailing license to the state
- Sending paper license copies to the state
- Review all license notifications that are received via mail or email, ensuring that the license is accounted for on the Secondary Filings Tracker and the appropriate secondary filings are entered in BLH, and filing in the applicable pharmacy folder on the shared drive
- Maintenance of the BLH database includes adding new records when additional Medicaid enrollments are approved, updating any dates based on information received from states, and running reports to confirm all required information is accurately noted in each record
- Review incoming emails regarding portal password resets, access the portals and reset the passwords and update the internal Portal Password Tracker
- Ensure the correct pharmacy license is provided to the state Medicaid agency including the correct pharmacy name and renewed expiration date. Verify the Medicaid ID, NPI and correct pharmacy name are included when sending pharmacy license to the state
**ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION**
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.
- Associate Degree or higher degree completed
- 1+ year of experience within a compliance/regulatory area
- 1+ year of experience working in a Call Center setting
- Data analysis experience
- Available to work (40 hours/week) Monday- Friday during our normal business hours of (8:00am to 5:00pm Central Time)
- Familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
- Professional English proficiency (verbal and written) -English proficiency assessment will be required after application
- Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
- Bachelor’s Degree
- Experience working with CMS
- Licensure experience
- General understanding of Medicaid and Medicare
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 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 the health system 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.
Job Keywords: UnitedHealth Group, UnitedHealthcare, training class, License Analyst, Licensure Analyst, Licensing Specialist, Compliance Analyst, San Juan, Optum, Puerto Rico