Pharmacy Authorization Specialist
2 weeks ago
Overview of the Role
Optum is a leading global organization committed to enhancing health outcomes through innovative technology. Our mission is to connect individuals with essential healthcare services, pharmacy benefits, and vital resources to promote healthier living. We pride ourselves on fostering a culture of diversity and inclusion, offering talented colleagues, comprehensive benefits, and opportunities for career advancement.
Key Responsibilities
- Provide expert customer service and support to members, customers, and healthcare providers.
- Handle incoming requests for prior authorizations for both formulary and non-formulary medications.
- Ensure compliance with legal and contractual obligations, including turnaround times and service level agreements.
- Document all interactions with callers in accordance with regulatory requirements.
- Manage a high volume of inbound calls, addressing prior authorization inquiries and resolving formulary and benefit issues.
- Utilize various computer systems and job aids to process authorizations accurately.
- Maintain a focus on patient safety and quality of work, ensuring a secure workspace.
- Resolve issues and complaints efficiently and effectively.
Training and Work Environment
- Comprehensive training program lasting 5 weeks, Monday to Friday.
- Post-training shifts will be 8 hours with a 1-hour lunch break, requiring flexibility in availability.
- Potential for scheduled overtime and holiday work based on business needs.
- Must have a secure home office setup.
Benefits
- Accrual of Paid Time Off from the first pay period, including 8 Paid Holidays and a Floating Holiday.
- Access to various Medical Plan options and Health Spending Accounts.
- Comprehensive Dental, Vision, Life, and Disability Insurance coverage.
- 401(k) Savings Plan and Employee Stock Purchase Plan.
- Education reimbursement and Employee Assistance Programs.
- Flexible work arrangements and additional voluntary benefits.
At Optum, we are dedicated to improving health equity and addressing health disparities. We believe in creating a diverse and inclusive workplace where all individuals can thrive. Optum is an Equal Employment Opportunity / Affirmative Action employer, ensuring that all qualified applicants 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.
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