About the Company
OptumRx, a UnitedHealth Group company, is a leading pharmacy benefit manager dedicated to making health care simpler and helping people live healthier lives. We are committed to clinical excellence, innovative technology, and a personalized approach to member care. Our team drives forward the future of pharmacy benefits, ensuring access to affordable and effective medications for millions.
Job Description
As a Senior Pharmacy Technician and Team Lead specializing in Professional Benefits at OptumRx, you will play a pivotal role in ensuring the accurate and efficient processing of complex pharmacy benefit claims and inquiries. This leadership position involves overseeing a team of pharmacy technicians, providing guidance, training, and support to maintain high standards of service and compliance. You will be responsible for handling escalated issues, implementing process improvements, and ensuring our professional benefits programs run smoothly. This role requires a deep understanding of pharmacy operations, benefit structures, and a passion for leading and developing others.
Key Responsibilities
- Lead, mentor, and provide day-to-day guidance to a team of pharmacy technicians, fostering a collaborative and high-performing environment.
- Oversee the processing of complex pharmacy benefit claims, prior authorizations, and member inquiries, ensuring accuracy and adherence to regulations.
- Act as a primary point of contact for escalated issues, resolving complex benefit concerns and providing expert solutions.
- Conduct regular quality assurance checks on team output, identifying areas for improvement and implementing corrective actions.
- Develop and deliver training sessions for new and existing team members on pharmacy benefit programs, systems, and compliance updates.
- Collaborate with pharmacists, benefit specialists, and other internal departments to optimize workflows and enhance service delivery.
- Monitor team performance metrics, preparing reports and presenting insights to management.
- Participate in the development and implementation of new benefit programs and operational procedures.
- Ensure strict compliance with all federal, state, and local regulations, as well as company policies, related to pharmacy benefits.
- Assist with scheduling, performance reviews, and other administrative tasks as a team lead.
Required Skills
- Minimum of 3 years of experience as a Pharmacy Technician, with at least 1 year in a lead or supervisory role.
- Demonstrated expertise in pharmacy benefit management (PBM) processes, prior authorizations, and claims adjudication.
- Strong leadership and team-building skills, with a proven ability to motivate and develop staff.
- Excellent verbal and written communication skills, capable of explaining complex benefit information clearly.
- Exceptional problem-solving abilities and attention to detail.
- Proficiency in pharmacy management software and Microsoft Office Suite (Word, Excel, Outlook).
- Ability to work effectively in a fast-paced, high-volume environment.
- Deep understanding of HIPAA and other healthcare privacy regulations.
Preferred Qualifications
- Associate's or Bachelor's degree in a related field.
- Current national Pharmacy Technician Certification (CPhT) from PTCB or NHA.
- Experience with OptumRx specific systems and professional benefit programs.
- Familiarity with various insurance plans and formularies.
- Project management experience or participation in process improvement initiatives.
Perks & Benefits
- Comprehensive health, dental, and vision insurance plans.
- 401(k) retirement savings plan with company match.
- Generous paid time off (PTO) and company holidays.
- Tuition reimbursement and professional development programs.
- Employee assistance program (EAP).
- Discount programs on various products and services.
- Opportunities for career growth within a leading healthcare organization.
- Life and disability insurance.
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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