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Senior Internal Audit Analyst - Cypress, CA or Irvine, CA or US Remote Relevant Educational Qualifications Job

3 months ago Other categories Cypress Hills   37 views
Job Details

As part of the OptumRx Commercial Client and Internal Audit Department, the Corrective Action & Preventative Action Management (CAPAM) Team works closely with management to ensure issues identified from various audit types are properly addressed through root cause analysis and the development of corrective and preventative actions. Our goal is to detect, correct, and prevent issues from reoccurring.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Training will be conducted virtually from your home.

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

Primary Responsibilities:

  • Manage all operational aspects of the CAPA (Corrective and Preventative Action) process including:
    • Working with the business to develop CAPAs in response to audit report issues from outside Consulting and Audit Firms; as well as, client delegation audits
    • Monitoring timely CAPA responses and implementation dates
    • Performing validation audits to ensure CAPAs were successfully implemented and producing the desired results
  • Track, trend, and report out CAPA metrics
  • Read and interpret benefit plan design documents and client contracts
  • Research historical claims on the RxClaim platform
  • Build relationships with both internal and external partners
  • Participate in key CAPA and continuous process improvement projects
  • Perform other related duties as assigned

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)
  • 3+ years of relevant work experience in the healthcare industry
  • 2+ years of experience in Microsoft Office, including Microsoft Word (creating and editing documents), Microsoft Excel (using formulas, filtering, pivot tables), and Microsoft PowerPoint (creating and editing decks)
  • 2+ years of experience analyzing business processes and workflows, including providing evaluations, benchmarking, and process improvement recommendations
  • If you need to enter a work site for any reason, you will be required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or similar UnitedHealth Group - approved symptom screener. When in a UnitedHealth Group building, employees are required to wear a mask in common areas. In addition, employees must comply with any state and local masking orders

Telecommuting Requirements:

  • Dedicated work area established that is separated from other living areas that provides information privacy
  • Ability to keep all company sensitive documents secure (if applicable)
  • Residing in a location that can receive a high - speed internet connection (additional information on UnitedHealth Group approved internet providers and restrictions will be provided)

Preferred Qualifications:

  • Healthcare and Pharmacy Benefit Management industry experience
  • Internal or Quality Auditing experience
  • Six Sigma Green Belt Certification or Experience with project management methodology (requirements, design, development, test and implementation)
  • Navigating the RxClaim platform and requesting prescription claims data

Soft Skills:

  • Excellent communication, time / project management, problem solving, organizational, and analytical skills
  • Strong oral and written communication skills, including presentation experience
  • Collaborating effectively with all levels of management to perform root cause analysis, develop CAPAs, and perform validation audits

UnitedHealth Group is an essential business. The health and safety of our team members is our highest priority, so we are taking a science driven approach to slowly welcome and transition some of our workforce back to the office with many safety protocols in place. We continue to monitor and assess before we confirm the return of each wave, paying specific attention to geography - specific trends. At this time, 90% of our non - clinical workforce transitioned to a work at home (remote) status. We have taken steps to ensure the safety of our 325,000 team members and their families, providing them with resources and support as they continue to serve the members, patients and customers who depend on us.

You can learn more about all we are doing to fight COVID - 19 and support impacted communities at: (please use the apply button below)

OptumRx 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.SM

Colorado Residents Only: The hourly range for Colorado residents is $25.63 to $45.72. Pay is based on several factors including but not limited to education, work experience, certifications, etc. As of the date of this posting, In addition to your salary, UHG offers the following benefits for this position, subject to applicable eligibility requirements: Health, dental, and vision plans; wellness program; flexible spending accounts; paid parking or public transportation costs; 401(k) retirement plan; employee stock purchase plan; life insurance, short-term disability insurance, and long - term disability insurance; business travel accident insurance; Employee Assistance Program; PTO; and employee-paid critical illness and accident insurance.

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 Care, UnitedHealth Group, Health care, RxClaim benefits, Microsoft Excel, Quality Auditing, Medicare, Medicaid, work at home, work from home, WAH, WFH, remote, telecommute, hiring immediately, #rpo

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Company Description
We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these select few, we offer the global reach, resources and can-do culture. We provide an environment where you’re empowered to be your best. We encourage you to take risks. And we offer a world of rewards and benefits for performance.