Senior Retail Medication Prior Authorization Coordinator
UnitedHealth GroupAbout the role
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.
Primary 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
What are the reasons to consider working for UnitedHealth Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:
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.)
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