Clinical Coding Consultant Pharmacist - RemoteUnitedHealth Group • Houston, Texas, United States
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Clinical Coding Consultant Pharmacist - Remote
UnitedHealth Group
- Houston, Texas, United States
- Houston, Texas, United States
About
Conducts 2ND Level Formulary/UM Claim Research
Implementation clinical coding support for BDS/cBDT/RxConstruct questions
GPI Reclass support/global Coding Change Support Drug utilization management
Commercial clinical audit support
Manage custom formulary coding work post client sign off
Translate client intent to code-able language for BOM team
Evaluate / resolve new rule design & conflicts with existing formulary coding
New Client Implementation coding support for custom formulary/UM programs
Extracts, evaluates and interprets clinical coding in adjudication & formulary management systems
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 of Science in Pharmacy or PharmD
Current and unrestricted Pharmacist license (any U.S. state)
2+ years of experience working as a Clinical Consultant or Clinical pharmacist working in Formulary/UM operations or Benefit administration
Experience conducting claims/coding research and analysis
Experience working within a PBM
Experience working in RX Claim or other claims adjudication system
Ability to navigate MS Office and a Windows based environment and the ability to create, edit, save, and send documents utilizing Microsoft Word; ability to navigate Outlook and conduct Internet searches
Intermediate to Advanced Proficiency with Microsoft Excel
Preferred Qualifications: MBA or other related advanced business degree
Experience using Microsoft Access or other database/query tools
Experience with Medi-Span drug classification system
Client-facing experience (beyond patients and prescribers)
*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.
Languages
- English
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