Pharmacist Intern Prior Authorization and Appeals Specialist

2 weeks ago

Houston, Texas, United States UnitedHealth Group Full time
Pharmacist Intern Prior Authorization and Appeals Role

At UnitedHealth Group, we're committed to helping people live healthier lives and making the health system work better for everyone. As a Pharmacist Intern with our Prior Authorization & Appeals team, you'll have the opportunity to work with a team of clinical pharmacists to achieve overall performance objectives to the satisfaction of clients, regulatory bodies, and our organization standards.

Key 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 our 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 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.
Requirements:
  • 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).

You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. At UnitedHealth Group, we believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. We're 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.

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