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Technician, Pharmacy
3 months ago
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.
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.
Requests can be received via fax or telephone, from providers' offices and pharmacists.The position provides clinical review for authorizations in keeping with legal and contractual requirements, including but not limited to turn around times (TATs) and service level agreements (SLAs).
Interactions with callers must be documented per contractual and various regulatory / legal requirements.If you live in the state of Wyoming, you will enjoy the flexibility to telecommute* as you take on some tough challenges.
Primarily answering prior authorization with inbound calls (up to 50 to 70 calls per day) from providers/members as well as research and resolve formulary and benefit issues using the appropriate reference materialProcess authorizations through various computer systems and use of job aid/policies/procedures ensuring the accuracy of all data and updating as necessary
Patient Safety and Quality of work is paramount and it's 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
Handles inbound phone requests and gathers member data to provide information for pharmacist consultations
Training is for 5 weeks. Training time is 8:00am-5:00pm local time. Monday- Friday. This training time is subject to change
Shift after training is an 8-hour shift with an hour lunch. Candidate must be available as early as 5am and as late as midnight
There may be scheduled overtime and/or working on holidays dependent on business needs
Candidate must also have a secure workspace/office in their home
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.
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 Assistance Program
~ Flexible Work Arrangement
~ 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 direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
The National Board of Prior Authorization Specialist
~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)
~ Ability to work any shift in the 7:00 AM to 12:00 AM timeframe with flexible hours, including OT and weekends
Experience and strong communication skills, both written and oral that will help improve Net Promoter Survey (NPS)
Frequent speaking, listening using a headset, sitting, use of hands/fingers across keyboard or mouse, handling other objects, long periods working at a computer
Have a secure workspace/office in their home
All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone.
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.
