Senior Retail Medication Prior Authorization Coordinator

UnitedHealth Group•Everett, WA

7d•$20 - $36•Hybrid

About The Position

The Senior Retail Medication Prior Authorization Coordinator is responsible for reviewing and processing requests for prior authorization of medication in accordance with insurance provider guidelines. This role requires a solid understanding of healthcare insurance policies, pharmacy benefit management, and medical terminology. 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. Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. Join us to start Caring. Connecting. Growing together. Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.

Requirements

High School Diploma/GED
1 plus years of Pharmacy Technician or a Medical Assistant experience OR 1+ year(s) of experience in a pharmacy setting
1+ year(s) of experience with basic computer software and keyboarding
Reside within a commutable distance to Everett and surrounding communities in Washington
Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
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
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

Nice To Haves

Current certification from WA State Department of Health as a Certified Medical Assistant or WA State Pharmacy Technician License
Knowledge of EMR (EPIC)
Proficiency with keyboarding, documentation, and processing prior authorizations

Responsibilities

Acquire and maintain a working knowledge of health plan formulary and authorization requirements
Utilize internal system to facilitate faster turnaround time on a complete authorization
Gather necessary information from chart review to submit prior auth request to insurance providers
Act as a liaison between providers, pharmacy, health plans and patients to support a timely medication authorization process
Communicate with providers, pharmacy, and patients to provide updates on the status of their prior auth request
Document in the patient electronic health record all medication authorization work provided following standard work guidelines
Provide and document in Epic medication authorization denials and health plan recommendation and or alternatives when provided
Ensure compliance with all relevant laws, regulations, and policies related to medication prior authorizations
Performs other duties as assigned