Sr Pharmacy Prior Authorization Technician - Remote in CO
Location: Golden, Colorado
Internal Number: 117000009
Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)
As a Pharmacy Prior Authorization Technician you will review prior authorization requests, compile chart notes from patients and providers in support of the request and may perform additional outreach to patients and providers to complete documentation. You will have the flexibility to telecommute* as you take on some tough challenges.
If you are located within the state of Colorado and possess Colorado Pharmacy Technician License, you will have the flexibility to work remotely* as you take on some tough challenges
Work closely and coordinate with the prior authorization team
Review coverage determination requests under policy using appropriate criteria, claims history and plan benefit rules, as allowed by scope
Compile medical notes (disease state, drug treatment history and current drug plan) from patient/provider in support of the request
Verify eligibility and drug coverage under the plan benefit design to determine appropriate claims processing
Review requests against coverage determination policy and approval protocol and may perform outreach for additional information as needed to support the requests
Approve and appropriately document coverage determination requests based on defined criteria
Update approved requests in claims systems
Escalate and forward applicable requests to pharmacist as needed
May answer patient and provider questions
May assist with patient and provider outreach with HEDIS measures, and refilling/updating prescriptions as permitted by protocol and scope
This role is equally challenging and rewarding. You'll need to work within multiple computer systems simultaneously as you respond to questions or provide specific medication details/clinical information. It's a fast paced, high-volume environment where our members are counting on us to deliver these important, sometimes life-saving medications in an accurate and efficient manner.
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.
High school diploma, GED or equivalent work experience
Active Pharmacy Technician License in the state of Colorado
5+ years of pharmacy technician work experience in a clinical setting navigating patient medical records and demographics
Experience utilizing excellent typing and data entry skills
Experience utilizing basic math skills, computing skills, and knowledge of medical and pharmaceutical terminology
Expertise in communicating with patients, providers, and team members.
Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Pharmacy/prescription data entry experience
Previous experience working with prior authorizations
Experienced in medication adherence
Working knowledge of HEDIS measures
Solid attention to detail, outstanding communication skills, and the ability to excel in a team environment
Independent, responsible, and self-directed
Able to adapt and change with workflow and shifting priorities
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Colorado Residents Only: The hourly range for Colorado residents is $16.00 to $26.88. Pay is based on several factors including but not limited to education, work experience, certifications, etc. 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.
*All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy
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.