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. The Senior Pharmacy Care Coordinator supports prior authorization operations through advanced administrative processing and pharmacy-focused coordination. This role does not perform clinical review or medical necessity determinations but applies knowledge of pharmacy benefits and workflows to ensure accurate case processing and support cost-effective medication utilization through provider outreach.
A 40-hour work week, Monday through Friday 8:00am to 5:30pm PST. Rotating Saturday between 8:00 am to 12:00 pm PST. The schedule will be determined by the supervisor upon hire.
Location : Remote Nationwide You will enjoy the flexibility to telecommute* from anywhere within the U. S. as you take on some tough challenges. Primary
Process and manage pharmacy prior authorization requests, ensuring completeness and accuracy of submitted information Review requests against established guidelines such as formulary and step therapy requirements to support appropriate routing and next steps Conduct outbound outreach to provider offices to communicate authorization requirements, formulary alternatives, or step therapy options Document case activity, outreach, and updates in system tools in accordance with standard procedures Coordinate with intake, clinical teams, and providers to ensure timely case progression and resolution of issues Identify and escalate complex or incomplete requests as needed Performs other duties as assigned 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
High School Diploma/GED 3+ years of experience in prior authorization, pharmacy operations, or healthcare administrative support 1+ years of organizational skills and ability to manage programs with outcomes 1+ years of computer proficiency experience Ability to work a 40-hour work week between 8:00am to 5:30pm and rotating Saturdays from 8:00 am to 12:00 Pacific Standard Time Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection and installation.
Candidate must have their own home internet access (internet can be hard wired with Ethernet cord) Must be on camera for all team's calls\meetings Required to have a location/workspace in the home that is separate from non-workspace areas and can be secured to maintain PHI or PII security in line with UnitedHealth Group policies and standard. Ability to keep all company sensitive documents secure (if applicable)
1+ years of experience as a pharmacy technician or medical assistant 1+ years of experience in a physician's clinic or hospital Experience with prior authorization workflows, case processing, and system documentation Previous Epic or similar Electronic Medical Record (EMR) experience preferred Knowledge of pharmacy terminology, drug classifications, and formulary concepts Soft
Operating a computer, calculator, photocopy machine, and document scanner Ability to work independently and maintain good judgment and accountability Demonstrated ability to work well with health care team Strong organizational and time management skills Ability to multi-task and prioritize tasks to meet all deadlines Ability to work well under pressure in a fast-paced environment Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others *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 $20 - $36 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.
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.
UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace.
Candidates are required to pass a drug test before beginning employment. #RPO, #GREEN