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. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.As a Pharmacist PA/Appeals you will perform live telephonic outreach to UHC Medicare members to improve health quality outcomes (i.e., medication adherence, appropriate drug utilization). This is your opportunity to join a pharmacy team with a focus on clinical and business collaboration. You will find an incredible team culture that provides opportunities to learn and evolve every day.You will enjoy the flexibility to telecommute from anywhere within the U.S. as you take on some tough challenges.Primary Responsibilities:
Decisioning and processing member prescriptions or prior authorizations through various computer systems ensuring the accuracy of all data and updating as necessary
Navigate across multiple computer systems to respond to questions or to provide specific medication details / clinical information
Receive incoming calls from members or providers; conduct outgoing calls as needed to provide follow-up or consultation such as prior authorization requirements, appeals, etc.
Apply benefit plan criteria in making decisions (approvals / denials) or recommendations; clarify and explain pharmaceutical benefits and procedures
Safety is paramount and it’s important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
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:
Current and unrestricted Pharmacist license in the state of residence
Beginner level of proficiency navigating MS Office and a Windows-based environment
Ability to work 7am to 7pm local time with the ability to work flexible hours, including OT and weekends
Preferred Qualifications:
Knowledge of call center systems such as CMS, IEX, CTI and TCS
All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii or Washington Residents Only : The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, or Washington residents is $42.31 to $83.27 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.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
