pas content Management decision tree analyst - taguig city, ncrUnitedHealth Group

Working in Operations at Optum, part of the UnitedHealth Group family of businesses, is one of the toughest and most fulfilling ways to help people, including yourself. We offer the latest tools, most intensive training program in the industry and nearly limitless opportunities for advancement. Join us and start doing your life's best work.(sm)
The Case Installations Account Service Representative performs employer benefit plan design coding to assigned accounts, including, but not limited to: structure building and revisions, and researching and resolving structure issues.
Position in this function are responsible for the installation of assigned accounts, including, but not limited to: structure building and billing set up, structure revisions, researching & resolving structure issues, database loading, and preparation of plan materials such as administrative documents and customer education materials. Positions are responsible for overall employer contract loading using various databases and/or source documents. May research installation issues & develop customer specific resolutions. May include auditing contract loads for adherence to quality measures and reporting standards. Work is frequently completed without established procedures.
Primary Responsibilities:
Perform generation of plan documents, including but not limited to, Summary Plan Descriptions (SPD), amendments, and Summary of Benefits and Coverage (SBC)
Use supporting documents (work orders, installation documents) to ensure our system is coded correctly and plan documents that are generated are accurate
Adhere to departmental guidelines and processes put in place for these tasks
Become familiar with current policies and procedures and other reference material
Provide feedback and explanation in a positive and professional manner
Work in a team environment while demonstrating individual accountability
Perform other duties as assigned
Work independently
May act as a resource for others
May coordinate others' activities
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
Eligibility
To apply to an internal job, employees must meet the following criteria:
At least 18 months tenure with Optum
At least ME rating from the last Common Review
No active Corrective action or not currently enrolled to PIP
Required Qualifications:
Graduate of Medical Allied Courses
At least 6 months of Prior Authorization experience
Above average communication skills, both oral and written
Moderate proficiency with Window s PC applications which includes the ability to learn new and complex
computer system applications
Preferred Qualification:
Degree in Pharmacy or Nursing
Preferably with working internet connection of at least 15 mbps in case of working from home. The following options are also available:
- Corporate internet subsidy for those within available and valid serviceable locations, subject to Company Policy
- Onsite work for those who are amenable to drive or commute to our office locations
Physical Requirements and Work Environment:
Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, and long periods working at a computer
Service center environment with moderate noise level due to Representatives talking, computers, printers, and floor activity
Ability to work a 5-day week, 8-hour shift, any time between office hours of operation
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: Optum is an Equal Employment Opportunity 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.
Optum is a drug-free workplace. © 2020 Optum Global Solutions (Philippines) Inc. All rights reserved.
Job Keywords: PAS Content Management Decision Tree Analyst, PA Rep, Employer Installation Representative, PAS, Prior Authorization, Taguig City, NCR, National Capital Region
UnitedHealth Group

Taguig City, Metro Manila
Permanent
Full-time