BGH Scout Logo

Pharmacy Care Coordinator

Optum · Health Care Equipment & Services
Viewed by 1 job seeker
Share:
Job Description:
REMOTE NATIONWIDEOptum 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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm)As a Specialty Prior Authorization Pharmacy Care Coordinator, your role will focus on submitting prior authorizations for specialty patients with acute and chronic disease states. In this role you will be preparing prior authorizations for submission, obtaining support documents for prior authorizations, follow up on prior authorization outcome, addressing issues and handling concerns from other corresponding departments. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:Initiating PA requests Reviewing clinical documentationReviewing provider PA submission preferences Validating insurance types (Medicaid, Medicare, Commercial, etc.)Accessing multiple Optum resources to check PA status and benefits Problem-solve with decisiveness and urgency and escalate to operations partners, team leads, management and other stakeholdersEnsure patients and providers are supported by following escalation through to finishEnters notes/information into pharmacy processing system.Focus on patient care and quality assuranceAble to work flexible hours between 7-7pm CST Monday to FridayWhat are the reasons to consider working for UnitedHealth Group?   Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:Paid Time Off which you start to accrue with your first pay period plus 8 Paid HolidaysMedical Plan options along with participation in a Health Spending Account or a Health Saving accountDental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage401(k) Savings Plan, Employee Stock Purchase PlanEducation ReimbursementEmployee DiscountsEmployee Assistance ProgramEmployee Referral Bonus ProgramVoluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)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: High School Diploma/GED1+ years of customer service experienceIntermediate level of proficiency with Microsoft Excel, Microsoft Word, Microsoft PowerPoint, and e-mail communicationAbility to work full-time with open availability between the hours of 7:00 AM - 7:00 PM CTPreferred Qualifications:Prior Authorization ExperienceLicensed Pharmacy TechnicianExperience in pharmacy or healthcareSoft Skills:Ability to manage multiple tasks and set prioritiesAbility to establish and execute action plans; able to share your past successesAbility to be diplomatic when faced with conflict, and always communicate in a professional and courteous mannerAbility to produce quality results with a detail-oriented focusGeneral knowledge of pharmacy laws, practices and proceduresKnowledge of insurance and third-party billing systems*All Telecommuters 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 hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. 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.  #RPO, #GREEN