Remote Pharmacist Appeals Specialist

UnitedHealth Group; Houston (TX); Remote; Confidential; Full time

Benefits offered by this job

Telecommuting

Job summary

UnitedHealth Group's UnitedHealthcare division is seeking a Pharmacist to evaluate prescriptions and support clinical decisions for appeals within the U.S. This role offers telecommuting options and a schedule that alternates between weekdays and weekends, with potential overtime.

The position requires a PharmD and active state license, plus 1+ year of pharmacist experience and PA decision experience. Strong written communication and computer skills are essential to succeed.

Qualifications

• PharmD degree required.
• Active and unrestricted Pharmacist license in your state.
• 1+ year of licensed pharmacist experience.
• 1+ year using online clinical references.
• 1+ year handling onscreen document images.
• 1+ year of professional business writing and communication.
• Experience with prior authorization decisions is preferred.
• Ability to work a rotating schedule including overtime.

Responsibilities

• Evaluate prescriptions and patient histories.
• Interpret prescriptions and clinical documentation; assess criteria.
• Consult with customers, patients and physicians regarding drug use and appeals.
• Conduct quality assurance and verify prescription accuracy for appeals.
• Provide explanations within area of expertise.
• Review formulary and utilization guidelines to determine coverage.

Skills

Business writing

Communication

MS Office

Windows environment

Prior authorization

Education

PharmD degree

Pharmacist license

Tools

MS Office

Windows-based tools

Job description

UnitedHealth Group's UnitedHealthcare division is seeking a Pharmacist to evaluate prescriptions and support clinical decisions for appeals within the U.S. This role offers telecommuting options and a schedule that alternates between weekdays and weekends, with potential overtime.

The position requires a PharmD and active state license, plus 1+ year of pharmacist experience and PA decision experience. Strong written communication and computer skills are essential to succeed.