Prior Authorization Pharmacist - Remote in Wyoming
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About The Position
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 essential functions of a Pharmacist in Prior Authorization involve reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design in a fast-paced environment. This is a dynamic work setting that requires flexibility to meet business needs and adaptability to frequent changes. This position is for a Clinical Pharmacist working in the Prior Authorization department of OptumRx, a UnitedHealth Group company. This is a call center-based business segment, and strict work guidelines are employed. If you are located in the state of Wyoming, you will have the flexibility to work remotely as you take on some tough challenges. Primary Responsibilities include working in a computer-based environment, gathering complex clinical information, and maintaining minimum productivity and quality targets as dictated by the department's internal performance matrix. You will need to have solid attention to detail, organize your workload, set priorities, complete assignments in a timely manner, and utilize resources appropriately while complying with department program standards. Certain job functions may include receiving phone calls from prior authorization pharmacy technicians and/or providers for clinical information, and consulting physicians/providers with questions. You will perform all duties and functions in compliance with state and federal pharmacy laws and regulations, and it is important to build rapport and maintain productive working relationships with coworkers, management, internal customers, and other departments by demonstrating a solid customer service orientation. Patient Safety and Quality of work 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. The training for this position includes 4 weeks of didactic training, followed by additional on-the-job training. Training time is from 8:00 am to 5:00 pm local time, Monday to Friday, and this training time is subject to change. After training, the shift is an 8-hour shift with a 30-minute lunch, unless dictated otherwise by law. Candidates must be available as early as 7:00 am and as late as midnight, with the usual shift being from 10:30 am to 7:00 pm local time. Candidates will work 5 days a week, with the possibility of a weekend shift every 4 weeks. There may be pre-scheduled overtime and/or working on holidays depending on business needs. Candidates must have access to a hard-wired internet connection and a secure office/workspace in their home. Technical savvy is required for working with PCs, and certain soft skills such as sitting, use of hands/fingers across keyboard or mouse, long periods working at a computer, and listening using a headset are necessary. Excellent attendance is a must throughout training and thereafter.
