Pharmacy Care Coordinator

Optum; Jeffersonville (IN); Remote; USD 25,000 - 44,000; Full time

Benefits offered by this job

Paid Time Off

Medical Plan options

Dental, Vision, Life Insurance

401(k) Savings Plan

Education Reimbursement

Employee Discounts

Employee Assistance Program

Voluntary Benefits

Job summary

Optum is seeking a Specialty Prior Authorization Pharmacy Care Coordinator to prepare and submit prior authorizations for specialty patients, gather supporting documents, and monitor outcomes. You will collaborate with providers and internal teams to resolve issues and ensure timely approvals.

This remote role allows telecommuting nationwide within the U.S., with flexible scheduling to support patient care across payer types.

Qualifications

• High School Diploma or GED.
• 1+ years of customer service experience.
• Intermediate proficiency with Microsoft Excel, Word, PowerPoint, and email communication.
• Ability to work full-time with open availability between 7:00 AM - 7:00 PM CT.

Responsibilities

• Initiating PA requests.
• Reviewing clinical documentation.
• Reviewing provider PA submission preferences.
• Validating insurance types (Medicaid, Medicare, Commercial, etc.).
• Accessing Optum resources to check PA status and benefits.
• Problem-solve with decisiveness and urgency and escalate to operations partners and stakeholders.
• Ensure patients and providers are supported by following escalation through to finish.
• Enter notes/information into pharmacy processing system.
• Focus on patient care and quality assurance.
• Able to work flexible hours between 7:00 AM - 7:00 PM CST Monday to Friday.

Skills

Customer service

Communication skills

Problem solving

Education

High School Diploma/GED

Tools

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Email

Job description

REMOTE NATIONWIDE

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. 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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and

your life's best work.(sm)

As a

REMOTE NATIONWIDE

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. 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. Come make an impact on the communities we serve as we help advance health equity on a global scale. Here, you will find talented peers, comprehensive benefits, a culture guided by diversity and inclusion, career growth opportunities and your life's best work.(sm) As a Specialty Prior Authorization Pharmacy Care Coordinator, your role will focus on submitting priorauthorizations for specialty patients with acute and chronic disease states. In this role you will be preparing prior authorizations for submission, obtaining support documents for prior authorizations, follow up on prior authorization outcome, addressing issues and handling concerns from other corresponding departments.

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

Primary Responsibilities

• Initiating PA requests
• Reviewing clinical documentation
• Reviewing provider PA submission preferences
• Validating insurance types (Medicaid, Medicare, Commercial, etc.)
• Accessing multiple Optum resources to check PA status and benefits
• Problem-solve with decisiveness and urgency and escalated to operations partners, team leads, management and other stakeholders
• Ensure patients and providers are supported by following escalation through to finish
• Enters notes/information into pharmacy processing system.
• Focus on patient care and quality assurance
• Able to work flexible hours between 7-7pm CST Monday to Friday

What Are The Reasons To Consider Working For UnitedHealth Group? 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. Some Of Our Offerings Include

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• 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 Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• 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.

Required Qualifications

• High School Diploma/GED
• 1+ years of customer service experience
• Intermediate level of proficiency with Microsoft Excel, Microsoft Word, Microsoft PowerPoint, and e-mail communication
• Ability to work full-time with open availability between the hours of 7:00 AM - 7:00 PM CT

Preferred Qualifications

• Prior Authorization Experience
• Licensed Pharmacy Technician
• Experience in pharmacy or healthcare

Soft Skills

• Ability to manage multiple tasks and set priorities
• Ability to establish and execute action plans; able to share your past successes
• Ability to be diplomatic when faced with conflict, and always communicate in a professional and courteous manner
• Ability to produce quality results with a detail-oriented focus
• General knowledge of pharmacy laws, practices and procedures
• Knowledge of insurance and third-party billing systems
• All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $18.00 to $32.00 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

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.

#RPO, #GREEN