Pharmacy Care | Antonio, TX

Pharmacy Care Technician

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Location: 19500 International Highway 10 West, Building 1, San Antonio, TX

Schedule: Monday to Friday 9:00am to 6:00pm CST with rotating Saturdays from 8:00am to 5:00pm CST

Primary Responsibilities:

• Conduct a high volume of outbound calls to members to discuss reasons for non-compliant to medication(s), schedule pharmacy telephonic appointments, and/or obtain important follow up information from providers. Outbound calls are made primarily using an auto dialer requiring precision to detail and adaptability to type of response needed
• May answer inbound calls from members and assists them with their inquiries. Routes calls to appropriate department if necessary
• Follows system scripting and validates member demographic information
• Documents the provider or member's record with accurate information obtained on the call
• Performs desk and on-site review of all claims documentation to validate correct billing and that payment made to contracted pharmacies is supported and appropriate
• Provides support to internal staff, subcontractors and providers with respect to Medicare drug related issues
• May serve as a subject matter expert for the Pharmacy team and mentor new employees to the team as necessary
• Participates in and contributes to the overall pharmacy quality improvement initiatives
• Collect and maintains eligibility information in an appropriate and confidential manner
• Enters all assigned applications within a specified time frame in order to ensure eligibility deadlines are met accordingly
• Exhibits excellent phone and communication skills while providing complete and accurate information to members
• Requests for additional or supplemental information via correspondence in order to complete applications
• Adheres to assigned schedule and quality metrics
• Uses a multi-lined telephonic system to answer calls regarding eligibility requirements and medication refill orders
• Follows all policy and procedures for the Medical Assistance Program
• Performs all other related duties as assigned

Required Qualifications:

• High School Diploma/GED (or higher)
• Active and unrestricted Pharmacy Technician license in the state of Texas
• National Pharmacy Technician Certification (Certified Pharmacy Technician)
• 2+ years of experience in a pharmacy setting
• 1+ years of experience in a customer service setting
• 1+ years of experience with Medicare Part D, particularly the pharmacy record review, claims, billing, and reimbursement rules
• 1+ years of experience with HIPAA Privacy and Security Rules and CMS security requirements
• 1+ years of experience with Microsoft Office, internet, and e-mail
• 6+ months of previous Call Center experience
• Intermediate level of proficiency in writing skills and ability to produce work free from typographical or spelling errors

Preferred Qualifications:

• PBM experience
• Advanced knowledge of NCPDP and other types of prescription drug claims
• Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies. Retail pharmacy experience
• Bilingual (English/Spanish)

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The hourly pay for this role will range from $17.98 to $32.12 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.