Senior Retail Medication Prior Authorization Coordinator

UnitedHealth Group • Everett, WA

7d • $20 - $36 • Hybrid

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.
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.
The Senior Retail Medication Prior Authorization Coordinator is responsible for reviewing and processing request 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.
Schedule: Monday-Friday, 8am-5pm PST
Location: Onsite for training at 7600 Evergreen Way, Everett WA for about 1-3 month training period and then will become fully remote.
Candidates must reside near Everett, WA or must be willing and able to commute to the Everett office at their own expense for training
If you live near Everett, WA, you will enjoy the flexibility of a hybrid-remote position as you take on some tough challenges.
This position follows a hybrid schedule with three in-office days per week.

Requirements

• High School Diploma/GED (or higher)
• 1+ years of Pharmacy Technician or a Medical Assistant experience OR 1+ years of experience in a pharmacy setting
• 1+ years of experience with basic computer software and keyboarding
• Must 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

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
• 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

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

Benefits

• 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.)

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees