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AllCare Health is seeking a Full-Time Medication Prior Auth (UM) Analyst II who thrives in a team environment and has the ability to provide exceptional service.
AllCare Health is a southern Oregon-based health organization, led by local physicians since 1994. In a progressive model of care, we combine medical, dental, and behavioral health services to provide Medicare, Medicaid insurance coverage to our members. We also provide support to our providers through AllCare Independent Physician Association and AllCare e-Health Services. As a certified B-Corp organization, we consider our impact on society and the environment which is something that has been a founding principle of ours since our inception more than two decades ago
The Medication Prior Auth (UM) Analyst II is responsible for processing medication prior authorization requests in a busy environment.
What youll be doing:
Processing medication prior authorization requests
Preparing requests for clinical review
Requesting medical records and information from Providers and Pharmacies
What we are looking for:
The ideal candidate will have a pharmacy technician certification (preferred) or have a background as a medical assistant.
Must have knowledge of therapeutic drug classes/drug names.
Must have experience with computer data entry, word processing, excel and typing.
Must have excellent verbal and written communication skills.
Ability to use judgement for decision making based on health plan criteria and ability to manage deadlines are critical requirements.
Familiarity with medical records, medical terminology, ICD-10 codes, pharmacy drug claim processing and knowledge of OHP and Medicare Part D.
What we offer:
Medical, Dental, Vision and Life Insurance
PTO (paid time off) and paid Holidays
Professional Development Opportunities
Opportunities to impact local Oregon communities
For consideration, please submit your resume, cover letter and a list of your professional references.
Please note-this is located at our office in Grants Pass and remote work is not available.
We look forward to hearing from you!
AllCare Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
