Pharmacist Intern Prior Authorization and Appeals

6 hours ago

Houston, United States Optum Full time

Internships at Optum. If you want an intern experience that will dramatically shape your career, consider a company that's dramatically shaping our entire health care system. Optum, part of the UnitedHealth Group family of companies, is a leading health services and innovation company dedicated to helping make the health system work better for everyone. With more than 94,000 people collaborating worldwide, Optum combines people, technology, data and action to improve the delivery, quality and efficiency of health care. Our internship opportunities provide a view of a rapidly evolving, incredibly challenging marketplace of ideas, products and services. Here, you'll work with some of the smartest people in the business on assignments that matter. Join us to start Caring. Connecting. Growing together.

As a Pharmacist Intern with OptumRx's Prior Authorization & Appeals team, you will get the opportunity to work with a team of clinical pharmacists to achieve overall performance objectives to the satisfaction of clients, regulatory bodies, and the organization standards.

Primary Responsibilities:

* Provide input on decisioning and processing member prescriptions or prior authorizations through various computer systems ensuring the accuracy of all data and updating as necessary
* Navigate across multiple computer systems to respond to questions or to provide specific medication details / clinical information
* Receive incoming calls from members or providers; conduct outgoing calls as needed to provide follow-up or consultation such as prior authorization requirements, appeals, etc.
* Apply benefit plan criteria in making decisions (approvals / denials) or recommendations; clarify and explain pharmaceutical benefits and procedures
* Gain insight into the different areas within the Prior Authorization Department
* Consistently exhibit behavior and communication skills that demonstrate the company's commitment to superior customer service, including quality care and concern with internal and external customers
* Adhere to having a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
* Comply with policies, rules and regulations set forth by the Board of Pharmacy, and other applicable regulatory bodies
* Use, protect, and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards

You will 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:

* Currently enrolled in a Doctor of Pharmacy program, with first year completed before start of internship
* Active licensure as a pharmacist intern in state Texas
* Must be eligible to work in the U.S. without company sponsorship, now or in the future, for employment-based work authorization (F-1 students with practical training and candidates requiring H-1Bs, TNs, etc. will not be considered)

Preferred Qualifications:

* Enrollment as a P2 or P3 student for the August 2025 academic year
* 3.5 or higher cumulative GPA
* Knowledge of medical and pharmacy terminology
* Proven solid oral and written communication skills
* Proven adequate mathematical, analytical, and critical thinking skills

You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

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.

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