Medicaid Program Manager Jobs in Puerto Rico (NOW HIRING)

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Licensing Specialist, in charge of secondary filings, is responsible for running reports from BLH and analyzing these Secondary Filings using a Tracker to ensure all are accounted for. The Secondary Filings Tracker includes license expiration dates, status of filing, method of license delivery to state, and follow up notes.  

This is a critical function in maintaining Medicaid provider enrollments as states can deactivate the enrollment if required documents are not received and their records updated timely. There is significant follow up involved to ensure the states have updated their records. This includes making phone calls to state Medicaid agencies and/or following up through email.

Primary Responsibilities:

• In order to maintain Medicaid provider enrollments for our owned pharmacies, the Government Programs licensing team is required to supply current Board of Pharmacy licenses, city/business licenses, and DEA. This is done in a variety of ways, ie:
  • Logging onto a portal and updating the expiration date and uploading the current license(s)
  • Faxing license to the state
  • Emailing license to the state
  • Sending paper license copies to the state
• Review all license notifications that are received via mail or email, ensuring that the license is accounted for on the Secondary Filings Tracker and the appropriate secondary filings are entered in BLH, and filing in the applicable pharmacy folder on the shared drive                
• Maintenance of the BLH database includes adding new records when additional Medicaid enrollments are approved, updating any dates based on information received from states, and running reports to confirm all required information is accurately noted in each record
• Review incoming emails regarding portal password resets, access the portals and reset the passwords and update the internal Portal Password Tracker
• Ensure the correct pharmacy license is provided to the state Medicaid agency including the correct pharmacy name and renewed expiration date. Verify the Medicaid ID, NPI and correct pharmacy name are included when sending pharmacy license to the state

**ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION**

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:

• 1 years of experience in an office environment managing time-sensitive deadlines
• 1 years of direct experience with Medicaid and Medicare provider enrollment
• Demonstrated experience collaborating with diverse stakeholders in a team-oriented setting
• Proven solid understanding of regulatory requirements and compliance processes, with proven ability to resolve licensing and compliance issues
• Demonstrated familiarity with computer and Windows PC applications, which includes the ability to learn new and complex computer system applications
• Adept at understanding complex concepts and applying sound judgment in compliance-related scenarios
• Available to work (40 hours/week) Monday- Friday during our normal business hours of (8:00am to 5:00pm Central Time)
• Professional English proficiency (verbal and written) -English proficiency assessment will be required after application

Preferred Qualifications:

• 3 years of experience with licensing processes and/or application systems
• 1 years of experience in a healthcare, insurance, or pharmacy setting
• Experience with clinical credentialing, licensure, or regulatory compliance
• Demonstrated familiarity with Boards of Clinical and Pharmacy website navigation
• Proven solid critical thinking and problem-solving skills to support licensure operations and resolve complex issues independently
• Proven effective written and verbal communication skills 

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 env

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.

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