You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

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 Pharmacy Customer Service Representative or As a Specialty Prior Authorization coordinator, your role will focus on notifying a provider when a prior authorization is required for specialty patients with acute and chronic disease states. In this role you will be preparing prior authorizations for submission, follow up on prior authorization outcome, addressing issues and handling concerns from other corresponding departments.

You’ve heard this all your life. Trust matters. Being trusted matters a lot. Here at OptumRx we’ve earned the trust of more than 65 million people who rely on us for the prescription drugs that improve their health and lifestyle. Now, we trust that you can take advantage of some of the best training and tools in the world to help serve our customers and their care providers.This is no small opportunity. This is where you can bring your compassion for others while building your career.

This position is full-time. Employees are required to work any 8-hour shift during our normal business hours of 7:00 AM - 7:00 PM CST, including the flexibility to work occasional overtime based on business need.

We offer 3 weeks of paid training. The hours during training will be 9:00 am - 5:30 pm EST, Monday - Friday. Training will be conducted virtually from your home.

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Primary Responsibilities:

Handle Initiating PA requests

Validating insurance types (Medicaid, Medicare, Commercial, etc.)

Accessing multiple Optum resources to check PA status and benefits

Problem-solve with decisiveness and urgency and escalate to operations partners, team leads, management and other stakeholders

Ensure patients and providers are supported by following escalation through to finish

Enters notes / information into pharmacy processing system.

Focus on patient care and quality assurance

This role is equally challenging and rewarding. You’ll be called on to research complex issues pertaining to member prescription and/or pharmacy benefits across multiple databases which requires fluency in computer navigation and toggling while confidently and compassionately engaging with the caller.

To learn even more about this position and hear from our other Pharmacy Customer Service Representatives, click here to watch a short video: http://uhg.hr/pharmCSRvideo

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:

High School Diploma / GED OR equivalent work experience OR 1+ year customer service or healthcare industry experience

Must be 18 years of age OR older

Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications

Ability to work any 8-hour shift between the hours of 7:00 AM - 7:00 PM CST including the flexibility to work occasional overtime based on business need

Ability to attend training from 9:00 am - 5:30 pm EST, Monday - Friday for 3 weeks

Preferred Qualifications:

1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools

Knowledge of insurance and third-party billing systems

General knowledge of pharmacy laws, practices and procedures

Prior Authorization Experience

Experience in pharmacy or healthcare

Telecommuting Requirements:

Ability to keep all company sensitive documents secure (if applicable)

Required to have a dedicated work area established that is separated from other living areas and provides information privacy

Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Soft Skills:

Demonstrated ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner

Maintain strict confidentiality and adhere to all privacy and security regulations when handling sensitive information

Ability to manage multiple tasks and set priorities

Ability to establish and execute action plans; able to share your past successes

Ability to be diplomatic when faced with conflict, and always communicate in a professional and courteous manner

Ability to produce quality results with a detail-oriented focus

California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, Rhode Island, OR Washington, D.C. Residents Only: The hourly range for this is $16.00 - $28.27 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.

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 .

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