About the Company
Optum, a part of UnitedHealth Group, is a leading health services innovation company dedicated to helping make the health system work better for everyone. We combine technology, data, and expertise to improve the delivery, quality, and efficiency of healthcare. Our SaaS platforms empower healthcare providers, payers, and patients to navigate the complexities of modern medicine with greater ease and effectiveness.
Job Description
We are seeking a detail-oriented and tech-savvy Prior Authorization Pharmacy Tech to join our innovative team. In this role, you will be instrumental in managing prior authorization requests for various medications, utilizing our advanced SaaS platform to streamline processes and ensure timely patient access to essential treatments. This position requires a blend of strong pharmacy knowledge, excellent communication skills, and comfort with technology to navigate our proprietary software and interact with healthcare providers and insurance companies.
Key Responsibilities
- Process prior authorization requests for prescribed medications efficiently and accurately using our SaaS platform.
- Verify patient insurance coverage and benefits related to medication prior authorizations.
- Communicate effectively with prescribers' offices, patients, and insurance companies to gather necessary information and provide status updates.
- Resolve complex prior authorization issues and appeals by collaborating with pharmacists and other healthcare professionals.
- Maintain meticulous records of all prior authorization activities within the designated software system.
- Stay updated on pharmaceutical drug lists, insurance plan changes, and prior authorization requirements.
- Identify and report any system or process inefficiencies within the SaaS platform to improve workflow.
- Adhere to all HIPAA regulations and company policies regarding patient confidentiality and data security.
Required Skills
- Certified Pharmacy Technician (CPhT) or equivalent state licensure/certification.
- Minimum 1 year of experience in a pharmacy setting, with specific experience in prior authorizations.
- Proficiency with pharmacy management software and general computer applications.
- Strong understanding of medical terminology, drug names, and common disease states.
- Excellent verbal and written communication skills.
- Exceptional attention to detail and organizational abilities.
- Ability to work independently and as part of a team in a fast-paced environment.
Preferred Qualifications
- Experience working with a SaaS-based healthcare or pharmacy platform.
- Associate's degree or higher in a related field.
- Bilingual (English/Spanish) a plus.
- Familiarity with various insurance formularies and appeals processes.
Perks & Benefits
- Comprehensive medical, dental, and vision insurance plans.
- 401(k) retirement savings plan with company match.
- Paid time off (PTO) and company-paid holidays.
- Opportunities for professional development and career advancement.
- Tuition reimbursement program.
- Employee wellness programs.
- Collaborative and innovative work environment.
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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