Requisition number: 2361819
Job category: Pharmacy
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.
Optum's Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.
The Senior Retail Medication Prior Authorization Coordinator is responsible for reviewing and processing request for prior authorization of medication in accordance with insurance provider guidelines. This role requires a solid understanding of healthcare insurance policies, pharmacy benefit management, and medical terminology.
Schedule: Monday-Friday, 8am-5pm PST
Location: Onsite for training at 7600 Evergreen Way, Everett WA for about 1-3-month training period and then will become fully remote.
Candidates must reside near Everett, WA or must be willing and able to commute to the Everett office at their own expense for training
If you reside near Everett, WA, you will enjoy the flexibility to telecommute* as you take on some tough challenges
Primary Responsibilities:
Acquire and maintain a working knowledge of health plan formulary and authorization requirements
Utilize internal systems to facilitate faster turnaround time on a complete authorization
Gather necessary information from chart review to submit prior auth request to insurance providers
Act as a liaison between providers, pharmacy, health plans and patients to support a timely medication authorization process
Communicate with providers, pharmacy, and patients to provide updates on the status of their prior auth request
Document in the patient electronic health record all medication authorization work provided following standard work guidelines
Provide and document in Epic medication authorization denials and health plan recommendation and or alternatives when provided
Ensure compliance with all relevant laws, regulations, and policies related to medication prior authorizations
Performs other duties as assigned
What 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 Holidays
Medical Plan options along with participation in a Health Spending Account or a Health Saving account
Dental, Vision, Life& AD&D Insurance along with Short-term disability and Long-Term Disability coverage
401(k) Savings Plan, Employee Stock Purchase Plan
Education Reimbursement
Employee Discounts
Employee Assistance Program
Employee Referral Bonus Program
Voluntary 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 directions 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/GED
1+ years of Pharmacy Technician or a Medical Assistant experience OR 1+ years of experience in a pharmacy setting
1+ years of experience with basic computer software and keyboarding
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
Reside within a commutable distance to Everett and surrounding communities in Washington
Preferred Qualifications:
Current certification from WA State Department of Health as a Certified Medical Assistant or WA State Pharmacy Technician License
Knowledge of EMR (EPIC)
Proficiency with keyboarding, documentation, and processing prior authorizations
Soft Skills:
Ability to work independently and maintain good judgment and accountability
Demonstrated ability to work well with health care providers
Strong organizational and time management skills
Ability to multi-task and prioritize tasks to meet all deadlines
Ability to work well under pressure in a fast-paced environment
Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others
*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 $20.38 to $36.44 per hour based on full-time employment. We comply with all minimum wage laws as applicable.
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.
RPO #GREEN
