• UnitedHealth Group
  • $81,450.00 -160,480.00/year*
  • Crystal Bay, NV
  • Scientific Research
  • Full-Time
  • 20 Crystal Peak Rd

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Energize your career with one of Healthcare's fastest growing companies.

You dream of a great career with a great company? where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it's a dream that definitely can come true. Already one of the world's leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum? A growing part of our family of companies that make UnitedHealth Group a Fortune 6 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

There comes a point when you're ready to take off the training wheels and start guiding others. If that's where you are today, let's talk about where you can be tomorrow with our leading, global health care organization. Here at UnitedHealth Group and our growing OptumRX pharmacy benefits business, we've earned the trust of more than 64 million people who rely on us for the prescription drugs that improve their health and lifestyles. Here's where you come in. As a Lead Pharmacy PA / Appeals Technician, your contributions will extend beyond fulfilling prescriptions. You'll incorporate your knowledge of specialty medications as you work through the authorization process including review of physician's letters of medical necessity and reviewing/approving requests for prescription prior authorizations. Along the way, you'll discover the training, support and career opportunities you'd expect from a Fortune 6 leader.

This role is equally challenging and rewarding. Strong attention to detail and computer skills are required as you confirm prescription orders and information for the automated fulfillment for accuracy. It's a fast-paced, high-volume environment where accuracy is essential. The role also requires you to monitor products that have been recalled to ensure safety protocols are followed.

Primary Responsibilities:

* Interpret physicians' prescriptions, create order, access / inputs / retrieve prescription information and verify reimbursement eligibility

* Processes prior authorization requests for any or all of the following: unit doses, specialty pharmaceuticals and infusible medications

* Review and manager team metrics and provide feedback on individual and team progress

* Ensure staff is clearly informed of all procedures and updates including ad hoc training, education, process updates, etc.

* Take escalated and / or supervisor calls

* This position has varying shifts that alternate quarterly

Required Qualifications:

* Active Pharmacy Tech License in good standing

* Knowledge of the Pharmacy Benefit Management and/or Health Insurance Industry from a customer support perspective

* Strong written and verbal communication skills

* Strong interpersonal skills

* Ability to effectively present information and respond to questions from groups of associates, managers and clients

* Ability to comprehend ACD statistical reporting and apply it to the operation of the department

* Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form

* Working knowledge of word processing, spreadsheet, and familiarity with scheduling software applications

* Ability to maintain a high level of consistency while working with team members

* Ability to recognize the needs of the staff, heighten morale, and decrease stress and burnout

* Ability to understand what style of conflict resolution is best suited for a particular situation

* Ability to determine the needs of each individual team member and assist them in achieving set goals

* Demonstrate a clear understanding of company and client confidentiality

* Excellent organizational and time management skills

* Exemplary coaching/motivational skills at both an individual and team level

* Adaptable and able to move with change while maintaining a positive attitude and strong role model for the Team

Preferred Qualifications:

* Knowledge of Call Center industry through work experience and as obtained through courses provided by ICMI or CIAC

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work. (sm)

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.

Job Keywords - Pharmacy Tech, Supervisor, Prior Auth, PA, Appeals, Insurance Pharmacy

Associated topics: biopharma, diet, dietary, dietician, disease, injury, nutritionist, pharmaceutical, transfection, virus

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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