We'll put you in the driver's seat on vital projects that have strategic importance to our mission of helping people lead healthier lives. Yes, we share a mission that inspires. We need your organizational talents and business discipline to help fuel ours. It's the opportunity to do your life's best work.(sm)
This Business Operations Specialist position is required to handle increased workload associated with Prior Authorization system setup. The Prior Authorization system setup includes the loading of letters, updating of tables, loading clinical guidelines, and updating automated decision trees.
This role is vital since without it we will risk incomplete guidelines, incomplete or incorrect approval and denial letters loaded for each client for each migration resulting in increased cost to client and decreased member satisfaction.
Core Competencies:
Strong writing and documentation skills
Organizational skills
Creativity
Requirements:
High School Diploma/GED
Basic proficiency in MS/Office (Word and Excel) is required
Research experience in AS400/RxClaim
Assets:
Bachelor's degree
Pharmacy Claims experience
Pharmacy Help Desk or RCR knowledge
Well-rounded business knowledge including standard prior authorization process
Well-rounded knowledge of the Pega or Pega Rules Process Commander (PRPC) application
Knowledge of Center for Medicare Services (CMS) Regulations
Knowledge of Prior Authorization Case turnaround times (TAT)
UnitedHealth Group is working to create the health care system of tomorrow.
Already Fortune 6, we are totally focused on innovation and change. We work a little harder. We aim a little higher. We expect more from ourselves and each other. And at the end of the day, we're doing a lot of good.
Through our family of businesses and a lot of inspired individuals, we're building a high-performance health care system that works better for more people in more ways than ever. Now we're looking to reinforce our team with people who are decisive, brilliant - and built for speed.
Come to UnitedHealth Group, and share your ideas and your passion for doing more. We have roles that will fit your skills and knowledge. We have diverse opportunities that will fit your dreams.
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. #LHCJobs UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
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Optum
Feb 20, 2026