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Optum Pbm Jobs in Indiana (NOW HIRING)

Optum Pbm information

What are some common challenges faced by professionals working in Optum PBM roles, and how can they be addressed?

Professionals in Optum PBM roles often encounter challenges such as navigating complex pharmacy benefit structures, managing evolving regulatory requirements, and balancing the needs of clients, members, and pharmacies. Effective communication and collaboration with cross-functional teams—such as clinical, IT, and client services—are essential to address these challenges. Staying current with industry trends and participating in ongoing training can also help team members adapt and succeed in this dynamic environment.

What is Optum PBM?

Optum PBM, or Optum Pharmacy Benefit Management, is a division of Optum (part of UnitedHealth Group) that manages prescription drug benefits on behalf of employers, health plans, and government programs. As a PBM, Optum negotiates with drug manufacturers and pharmacies to control costs and improve access to medications for members. They also provide services such as formulary management, mail-order pharmacy, and clinical programs to ensure safe and effective medication use. Optum PBM aims to balance cost savings with quality care for its clients and their members.

What is the difference between Optum Pbm vs Pharmacy Technician?

AspectOptum PbmPharmacy Technician
CredentialsVaries; often requires certification or licensure depending on roleHigh school diploma or equivalent; certification preferred
Work EnvironmentCorporate healthcare setting, call centers, or administrative officesRetail or hospital pharmacy settings
Employer & IndustryHealthcare and pharmacy benefit management companiesPharmacies, hospitals, or healthcare facilities
Job FocusManaging pharmacy benefits, processing claims, customer servicePreparing medications, customer assistance, inventory management

Optum Pbm roles focus on pharmacy benefit management, including claims processing and customer support, often requiring specialized certifications. Pharmacy Technicians work directly in pharmacies, assisting with medication preparation and customer service. While both roles are integral to healthcare, they differ in responsibilities, work environment, and required credentials.

What are the key skills and qualifications needed to thrive as a Pharmacy Benefit Manager professional at Optum, and why are they important?

To thrive as a PBM professional at Optum, you need a solid understanding of pharmacy benefit management, healthcare regulations, and data analysis, often supported by a degree in pharmacy, healthcare administration, or a related field. Familiarity with pharmacy claims processing systems, formulary management tools, and industry certifications such as CPhT or PBM-specific training is typically required. Strong analytical thinking, attention to detail, and effective communication skills help professionals collaborate with clients, providers, and internal teams. These competencies are vital for optimizing pharmacy benefit plans, ensuring regulatory compliance, and delivering cost-effective, high-quality patient care.
What cities in Indiana are hiring for Optum Pbm jobs? Cities in Indiana with the most Optum Pbm job openings:

PBM Account Manager - Remote

UnitedHealth Group

Michigan City, IN • Remote

Full-time

Retirement

Posted 7 days ago


UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 146 frontline employees who took The Breakroom Quiz

188th of 887 rated healthcare providers


Job description

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 Account Manager is responsible for driving client satisfaction by managing ongoing contract relationships and service delivery to client accounts. This role acts as an outward-facing, dedicated resource for assigned accounts, typically with direct client contact for large/complex accounts. The Account Manager builds client relationships and serves as the primary point of contact for overall & day-to-day service delivery by working closely with the internal partners. This role represents clients internally and coordinates with other functions to capture and support client requirements, complete projects, and address ongoing service needs. This role supports designated account team leaders in ongoing account upsell activity and renewals.

This position is full-time Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 5:00pm CST. 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:

  • OPERATIONAL MANAGEMENT
    • Facilitate all operational ongoing maintenance (benefit updates, file updates, etc.) & ensure it is successfully executed on
    • Own the day-to-day service experience of customers by working with the Operations Team and other functional partners as required to ensure issues are resolved promptly and accurately meeting the customer's expectations
    • Facilitate resolution of all escalated requests by working with the Operations Service Team and conducting customer consultations as required
    • Develop and maintain strong relationship with internal partners in Operations Service Team to manage customer service experience
      Coordinate activities to support impact reporting, root cause analysis, and full remediation
    • Ability to read, analyze and interpret SOPs and reporting
    • Coordinate implementation activities for new products and new groups
    • Coordinate annual open enrollment activities
    • Perform other assignments and responsibilities as required by management
    • Coordinate 1/1 readiness activities; facilitate daily 1/1 updates/progress reports with client and internal functional partners
    • Coordinate training of all OptumRx client-facing systems & tools
      Med D; understands basic CMS compliance requirements, delivers guidance memos to client; coordinates activities related to Corrective Action Plans (CAPs)
  • CLIENT RELATIONSHIP MANAGEMENT
    • Establish and maintain strong and appropriate relationships with customers to maintain consistency and drive client satisfaction
    • Maintain client action logs and facilitate regular cadence of discussions to review
    • Conduct meetings with customers to identify issues / trends and analyze root causes to determine corrective action steps as necessary
    • Demonstrate a high level of knowledge pertaining to the customer's specific benefit design
    • Understand, define, translate, communicate, and execute on client requirements

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:

  • 2 years of external client-facing experience
  • Experience with project coordination/facilitation
  • Experience with Microsoft Office applications (create, navigate, edit, save and send documents)
  • Experience with conflict resolution with both internal and external partners
  • Proven ability to learn PBM tools to drive operational activities (reporting tools, issue management tools, claims adjudication, etc.)
  • Ability to travel up to 25% of the time
  • Ability to work any 8-hour shift between the hours of 8:00am - 5:00pm CST including the flexibility to work occasional overtime based on business need
  • Driver's License and access to a reliable transportation

Preferred Qualification:

  • 1 years of PBM experience

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer 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 us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

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.

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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