Job Abstract

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 startCaring. Connecting. Growing together.

The essential functions of aSeniorPharmacy PA Appeals Technicianin Prior Authorization are providing expertise and customer service support to members and customers. This position exists to take incoming requests for prior authorizations, for formulary and non-formulary medications, while ensuring a high level of customer service and maximizing productivity. The technician must provide the information clearly, accurately and in a professional manner. Interactions with callers must be documented per contractual and various regulatory / legal requirements.

Youll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from members as well as research and resolve formulary and benefit issues using the appropriate reference material
• Process member prior authorization requests through various computer systems and use of job aid/policies/procedures ensuring the accuracy of all data and updating as necessary
• Have sharp attention to detail, using established criteria and guidelines, the pharmacy technician receives and processes prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan
• Patient Safety and Quality of work is paramount and its important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
• Resolve issues and complaints in a timely manner
• Performs other duties as assigned by management
• Shift after training is an 8-hour shift with a 30 minute lunch. Candidate must be available as early as 7am and as late as 9pm CST
• Candidate will work 5 days a week which may or may not include a weekend day(s)
• There may be scheduled overtime and/or working on holidays dependent on business needs
• Candidate must have their own home internet access (internet can be hard wired with Ethernet cord)
• Candidate must also have a secure workspace/office in their home
• Candidate must have level skill with working with PC (ex. using mouse and keyboard, accessing, and navigating through multiple systems and screens)
• Excellent attendance is a must

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 + Floating Holiday
• 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
• Flexible Work Arrangement
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at:http://uhg.hr/uhgbenefits

Youll 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:

• Must have one of the following licensures:
• Active National Pharmacy Certification or State Board Pharmacy Technician Licensure
• Pharmacy Technicians Certification Board (PTCB)
• State Board of Pharmacy Licensure in state of residence
• ExCPT Pharmacy Technician Certification with National Healthcareer Association (NHA)
• The National Board of Prior Authorization Specialist
• 6 + months of Customer Service/Customer Relations experience with Healthcare professionals
• Basic level of proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails)
• Able to work 7am to 9pm CST with ability to work flexible hours, including OT and weekends

Preferred Qualifications:

• Knowledge of Call Center systems such as IEX

Soft Skills:

• Experience and strong communication skills, both written and oral that will help improve Net Promoter Survey (NPS)
• Ability to follow through on tasks
• Physical Requirements and Work Environment:
• Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
• Ability to have their own home internet access (internet can be hard wired with ethernet cord)
• Have a secure work space/office in their home
• Have level skill with working with PC (ex. using mouse and keyboard, accessing and navigating through multiple systems and screens)

*All Telecommuters will be required to adhere to UnitedHealth Groups Telecommuter Policy.

California, Colorado, Nevada,Connecticut,New York, New Jersey,Rhode Island, Hawaii orWashington Residents Only:The hourly range forCalifornia, Colorado, Nevada,Connecticut,New York, New Jersey,Rhode Island, orWashingtonresidents is $16.54 to $32.55 per hour.Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc.UnitedHealth Group complies with all minimum wage laws as applicable.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, youll find a far-reaching choice of benefits and incentives.

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 everyoneof every race, gender, sexuality, age, location, and incomedeserves 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 Groupis a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO, #Green