Full Time Remote Clinical Pharmacist

Senior Pharmacy PA/Appeals 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 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. The essential functions of a Senior Pharmacy PA/Appeals Technician are providing expertise and customer service support to members, customers, and/or providers. This position exists to take incoming requests for prior authorizations, for formulary and non-formulary medications, while ensuring a high level of customer service and maximizing productivity. Requests can be received via fax or telephone, from providers' offices and pharmacists. Interactions with callers must be documented per contractual and various regulatory / legal requirements.

Position Schedule: Ability to work any shift from 7:00 AM to 7:00 PM timeframe with flexible hours, including OT

If you reside within the states of Wyoming, you will enjoy the flexibility to telecommute* as you take on some tough challenges.

Work is computer based, and is comprised of gathering complex clinical information, coverage policy and criteria information while working within regulatory guidelines to make coverage determinations

Maintain minimum productivity and quality targets as dictated by the department's internal performance matrix

Certain job functions may include receiving phone calls from prior authorization pharmacy technicians and/or providers for clinical information, and consulting physicians/providers with questions

Perform all duties and functions in compliance with state and federal pharmacy laws and regulations

Dedication to build rapport and maintain productive working relationships with coworkers, management, internal customers, and other departments by demonstrating a solid customer service orientation and a continuous positive image of OptumRx

Patient Safety and Quality of work is paramount and it's important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised

Didactic training is 4 weeks, followed by additional on the job training

Shift after training is an 8-hour shift with a 30-minute lunch, unless dictated otherwise by law. Candidate must be available as early as 7:00 am and as late as 7:00pm local time

There may be pre-scheduled overtime and/or working on holidays dependent on business needs

Candidates must also have a secure office/workspace in their home

initial setup of equipment, accessing and navigating through multiple systems and screens)

Candidate should have certain soft skills such as sitting, using hands/fingers across keyboard or mouse, long periods working at a computer, and listening using a headset

Excellent attendance is a must throughout training and thereafter

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. 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 Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

D. degree or Bachelor's degree in Pharmacy

Proven solid drug product and clinical pharmacy knowledge

Demonstrated ability to work independently with minimal supervision

Proven solid clinical ability to interpret criteria and implement clinical programs for prior authorization

Proven computer and typing proficiency, including with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document), and Microsoft Outlook (ability to send emails), and SharePoint

1+ years of experience working as clinical pharmacist

• Experience working in Prior Authorization
• Proven working knowledge of Medicare Part D, CMS regulations, NCQA, and State regulations

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). The hourly pay for this role will range from $44 - $79 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. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. 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. UnitedHealth Group