Pharmacy Auditor | Earn Up to 25K+ monthly | Temporary Work At Home

WHO WE ARE

Optum is a part of the UnitedHealth Group, a Fortune 5company, serving 125 million individual consumers.We are a diverse company with over 189,000 employees worldwide and over 14,000 employees in the PhilippinesWe are a leader in nearly every aspect of today’s health care landscapeWe leverage on having the largest single proprietary network of physicians, hospitals, health facilities, and caregivers in the United States. At Optum, we believe that what makes you special can inspire your life’s best work.

Welcome to one of the toughest and most fulfilling ways to help people, including you. 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

Join us today and unlock a world of rewards and benefits for performance, career growth, work-life balance and the opportunity to pursue your passion.

JOB QUALIFICATIONS

A graduate of BS Pharmacy and must have an active LicenseDepth knowledge of pharmacy operationsMust be willing to work on night shift schedule (9pm-6am); Fixed Weekends offMust be willing to attend 2 weeks - 1 month onsite training in Quezon City; Temporary Work-From-Home/ Hybrid schedule upon training completion, Computer/Laptop provided by the Company. Willing to report onsite in Quezon City is necessitated by the business; shuttle service provided

WHAT WE OFFER

Market Competitive Pay LevelsRetirement PlanMedical Plan (HMO) from Day 1 of employmentWork from Home (Hybrid) set upDental, Medical, and Optical ReimbursementsLife and Disability InsurancePaid Time-Off BenefitsSick Leave ConversionTuition Fee ReimbursementEmployee Assistance Program (EAP)Annual Performance based Merit IncreasesEmployee RecognitionTraining and Staff DevelopmentEmployee Referral ProgramEmployee Volunteerism OpportunityAll Mandatory Statutory Benefits

ROLE AND RESPONSIBILITIES

Positions in this function analyze and monitor real-time pharmacy claims against fraud, waste, abuse and errors related to retail pharmacy and long term care networks.Review system flagged claim for issue type and risk score, follow up with dispensing pharmacy to determine if claim was processed with missing or inaccurate information, send update to data as appropriate.Investigate, review and analyze claims data applying knowledge of pharmacy policy ang practice and data mining techniques to determine details of fraudulent, erroneous, or abusive billing activity.

Your role is critical in allowing our members, families, facilities and health professionals to have greater confidence in the exceptional care we provide. And for you, an everyday opportunity to do your life’s best work.SM