Pharmacy Care Associate Technician

2 weeks ago

San Antonio, Texas, United States Optum Full time
Position Overview

$1,000 SIGN ON BONUS FOR EXTERNAL APPLICANTS

Optum is a leading global organization committed to enhancing healthcare through innovative technology, empowering millions to achieve better health outcomes. By joining our team, you will play a crucial role in connecting individuals with essential care, pharmacy benefits, and vital resources. Our culture is rooted in diversity and inclusion, fostering an environment of talented professionals, comprehensive benefits, and ample career advancement opportunities. Together, we can make a significant impact on the communities we serve while promoting health equity on a global scale.

The Pharmacy Care Associate Technician is responsible for initiating outbound communications with members and healthcare providers to enhance medication adherence and improve pharmacy-related quality metrics. This role involves collecting prescription refill requests, delivering exceptional customer service, and assessing the eligibility of members seeking assistance through the Medical Assistance Program.

Work Schedule: Monday – Friday, 9am – 6pm with rotating Saturdays every four weeks (Initial training period will be Monday – Friday, 8am – 5pm)

Key Responsibilities:

  • Engage in a high volume of outbound calls to members to address medication non-compliance, schedule pharmacy consultations, and gather essential follow-up information from healthcare providers. Outbound communications will primarily utilize an autodialer, requiring attention to detail and adaptability to various responses.
  • Handle inbound calls from members, assisting with inquiries and directing calls to the appropriate department when necessary.
  • Adhere to system scripts while verifying member demographic information.
  • Accurately document interactions with providers or members in their respective records.
  • Conduct thorough reviews of claims documentation to ensure accurate billing and validate payments made to contracted pharmacies.
  • Provide support to internal staff, subcontractors, and providers regarding Medicare drug-related inquiries.
  • Contribute to pharmacy quality improvement initiatives.
  • Maintain eligibility information confidentially and appropriately.
  • Timely enter all assigned applications to meet eligibility deadlines.
  • Exhibit excellent communication skills, ensuring members receive complete and accurate information.
  • Request additional information through correspondence to finalize applications.
  • Adhere to assigned schedules and quality performance metrics.
  • Utilize a multi-line phone system to address inquiries regarding eligibility and medication refill requests.
  • Comply with all policies and procedures related to the Medical Assistance Program.
  • Perform additional related duties as assigned.
  • Demonstrate fine motor skills to operate office equipment and machinery.
  • Effectively comprehend and follow verbal and written instructions.
  • Employ logical reasoning for both simple and complex problem-solving tasks.

In this role, you will be recognized and rewarded for your contributions in a challenging environment that provides clear guidance for success and opportunities for professional growth.

Required Qualifications:

  • High School Diploma / GED (or higher)
  • Active and unrestricted Pharmacy Technician license in the state of Texas
  • National Pharmacy Technician Certification (CPhT)
  • 1+ years of experience in a pharmacy environment
  • 1+ years of experience in customer service
  • 6+ months of prior call center experience
  • Basic understanding of Medicare Part D, including pharmacy record review, claims, billing, and reimbursement regulations
  • Basic knowledge of HIPAA Privacy and Security Rules and CMS security requirements
  • Proficient writing skills with the ability to produce error-free documentation
  • Basic proficiency in Microsoft Office, Internet, and email, ensuring work is free from typographical errors
  • Ability to remain seated for extended periods.

Preferred Qualifications:

  • Bilingual (any language)
  • Experience in Pharmacy Benefit Management (PBM)
  • Advanced knowledge of NCPDP and various prescription drug claims
  • Familiarity with Medicare Part B and Part D coverage guidelines and payment methodologies
  • Previous experience in retail pharmacy

At UnitedHealth Group, our mission is to promote healthier lives and improve the health system for everyone. We believe in equitable access to health for all individuals, regardless of race, gender, age, or income. We are dedicated to addressing health disparities and enhancing health outcomes globally.

UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer. 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 maintains a drug-free workplace. Candidates must pass a drug test prior to employment.

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