Senior Utilization Management Pharmacy Technician

At Devoted Health, we’re on a mission to dramatically improve the health and well-being of older Americans by caring for every person like family. That’s why we’re gathering smart, diverse, and big-hearted people to create a new kind of all-in-one healthcare company — one that combines compassion, health insurance, clinical care, service, and technology - to deliver a complete and integrated healthcare solution that delivers high quality care that everyone would want for someone they love. Founded in 2017, we've grown fast and now serve members across the United States.  And we've just started. So join us on this mission!

Job Description

A bit about this role: 

As the UM Senior Pharmacy Technician at Devoted you will support the medical management operations of the health plan. You’ll be an important part of helping us build strong relationships with network health care providers by addressing escalated issues through outreach and follow-up communication. This is a fast paced company that will come with ebb, flows and last minute changes. A successful candidate will be outgoing, detail-oriented and have a natural talent for customer service and team leader. We often require management of several tasks at once so enthusiasm and organization are key. 

Your Responsibilities and Impact will include:

• Perform daily and weekly audits for the Intake process to ensure accuracy and compliance

• Perform weekly internal routine audits of utilization management (UM) processes to ensure adherence to policies, guidelines, and compliance standards

• Provide support to team members by answering questions and offering guidance to resolve issues

• Assist the Leadership team with escalating issues, including providing action steps for team members and handling escalation calls

• Contribute to process improvements by creating, reviewing, and updating documentation

• Collaboration with leaders from other teams will be required

• Conduct cross-functional training for Intake and UM Pharmacy Technicians

• Support special projects as needed

• Monitor work queues daily to verify tasks are completed on time, ensuring compliance metrics are met

• Available to act as the point of contact and take over project management responsibilities in the absence of the manager, ensuring continuity and progress

• Assist in monitoring offshore clinical partners and provide support to ensure workflow efficiency

• Offer assistance to the team during unexpected work overloads, including triaging and entering incoming PA requests and reviewing them according to company policies and decision trees

• Central Time or Mountain Time business hours preferred

• Available to rotate weekends and holidays

• Available to cover team members' PTO, including all time zones
   

Required skills and experience:

• Nationally Certified Pharmacy Technician (CPhT) with a minimum of three years of professional experience in the field

• Experience with Medicare Part B operations (e.g. pharmacy help desk, utilization management, prior authorizations)

• Prior experience in utilization management preferred

Desired skills and experience: 

• A strong desire to continue to work closely with aging patient populations.

• Experience caring for Medicare patients

• Proficient in technology - you’ll be working in Gmail /G Suite

• A history of being organized and having high attention to detail - it’s the little things that matter

• Experience with LLM

Salary Range: $26-$30 / hour

Our ranges are purposefully broad to allow for growth within the role over time. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered may depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.

Our Total Rewards package i