Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

IBX CARE Specialist are responsible for researching and resolving complex issues received by internal business partners and clients for one or more assigned clients with a book of business. Individuals in this role will utilize their comprehensive customer service and pharmacy expertise to research, solution, and resolve a wide range of issues, requests, and inquiries.

CARES Specialists act as a resource to members, internal business partners, and clients, use their subject matter expertise to root cause problems, and coordinate implementation of recommended solutions by working collaboratively with internal departments (i.e., Account Management, BOM, Customer Service, etc.). They directly interact with members to assist with issue resolution and education. Client interaction will also be necessary in this role, as needed.

CARES Specialists may also work with internal leadership to assist with projects and address ongoing new client needs. Ideal candidates are comfortable working independently with minimal direction and oversight to complete their assigned work each day.

This position is full-time (40 hours/week) and can include hours from 6:00 am to 11 pm (Central Time). Employees are required to have flexibility to work any of our 8 – 10 hour shift schedules during our normal business hours. It may be necessary, given the business need, to work occasional overtime.

You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Proficient understanding of customer needs (member, client, internal business partner) to ensure they are met

• Comprehensive understanding of applicable systems (i.e., RxClaim, Navigator, ServiceNow, etc.) and internal business procedures to appropriately provide information to clients and members

• Build rapport with clients and members by quickly responding to their concerns in a compassionate manner, delivering on commitments, and exceeding their expectations

• Serve as an internal escalation point of contact and liaison between client/account management and internal business departments to coordinate the research and resolution of issues, inquiries, and requests

• Dedicated contact to research and resolve any issues, inquiries, and/or requests for one or more assigned clients

• Support high touch clients as determined by plan design, issue trends, and current relationship

• Complete research and analysis of client and/or member issues to identify and implement solutions

• Identify and coordinate internal resources across multiple business departments to address client and member escalated issues

• Act as an advocate on behalf of the client and/or member to ensure their needs are met

• Escalate client and/or member issues to appropriate internal resources and leadership to ensure full resolution is provided

• Identify and remediate root cause for assigned cases and tasks

• Pinpoint client level issue trends and partner with Client Management to address identified opportunities for improvement

• Identifies solutions to non-standard client requests and problems

• Support implementation of new clients and existing client plan changes to ensure minimal disruption to members

• Act as a subject matter expert and provide education to clients and members on benefits and services

• Maintain a strict adherence to established quality guidelines, including appropriate assignment of issue and sub-issue types and thorough documentation in tracking tool (ServiceNow, Salesforce)

• Demonstrate the appropriate sense of urgency for all cases based on the nature of the request as well as the assigned Service Level Agreements (SLA)

• Ensure all SLA goals are met based on submitter and request type; includes managing priorities at individual desk level and timely escalation to ensure timelines are met

• Mentor, coach, train, and onboard Associate CARES Specialists, as needed

• Support internal leadership with the completion of projects that address ongoing or new client/member needs

• Provide feedback and recommendations to internal leadership to improve the efficiency and delivery of issue resolution for clients/members

• Role responsibilities may also include attending client calls on a regular basis and participating in onsite client meetings/benefit fairs

• Accountable for results from issue management related service questions in voice of client survey (NPS) depending on book of business supported

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:

• 3+ years of service experience (i.e., retail, call center, etc.) interacting with customers, assisting with escalated issues, and solving problems

• 3+ years of pharmacy experience with a PBM, retail pharmacy, etc

• Demonstrated subject matter expertise in OptumRx processes and operations

• Comprehensive knowledge of OptumRx products and systems required (i.e., RxClaims)

• Proficiency thinking analytically and strategically to solve highly complex problems and identify solutions

• Demonstrated solid written and verbal communication skills with proven ability to write clear, concise, and accurate messages for a variety of audiences

• Proven ability to work independently with minimal direction and procedures

• Demonstrated excellent organization and prioritization skills

• Experience mentoring, coaching, and supporting team members, leadership, and internal partners

• Ability to work any assigned 8-hour shift during standard business hours (7am to 7pm local time) Monday – Friday with some weekends, holidays and/or overtime as business needs dictate

Preferred Qualifications:

• Pharmacy Technician certification

• Experience working in a client facing role

• Account and/or Client Management experience

• Work experience in multiple functions within OptumRx

• Experience utilizing ServiceNow and/or Salesforce in an issue management environment

• Internal Candidates: Annual performance review rating of Meets Expectations or better for at least 2 consecutive years

*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Rhode Island, Washington, Washington, D.C. Residents Only: The hourly range for this role is $23.22 to $45.43 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

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 .

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 .

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