As one of the largest pharmacy benefits managers in the United States, UnitedHealth Group provides a professional culture where you're empowered and encouraged to exceed the expectations of our members, with better schedules than retail and more reach than any hospital. At Optum, a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader, you'll find better schedules than retail and more reach than any hospital. You'll open doors for yourself that simply do not exist in any other organization, anywhere. Take this opportunity to start doing your life's best work.(sm)
Optum Puerto Rico Operations is creating an innovative approach to Pharmacy Benefit Management. As a Pharmacy Technician - Prior Authorization, you will be responsible for the accurate and timely processing of prescription orders, answering incoming calls, completing outbound calls to/from patients, physicians and pharmacists while ensuring a high level of customer service and maximizing productivity.
This role is equally challenging and rewarding. You will help identify problems and determine solutions both independently or in a team/group setting. You’ll need to work within multiple computer systems simultaneously as you respond to questions or provide specific medication details/clinical information. It’s a fast paced, high volume environment where accuracy is essential.
- Process member prescriptions or prior authorizations through various computer systems ensuring the accuracy of all data and updating as necessary
- Navigate across multiple computer systems to respond to questions or to provide specific medication details/clinical information
- Receive incoming calls from members or providers and conduct outgoing calls as needed to provide follow-up or consultation such as prior authorization requirements, appeals, etc.
- Apply benefit plan criteria when making decisions (approvals/denials) or recommendations
- Educate members and providers on pharmaceutical benefits
- Partner with others to gather additional information and/or to interpret clinical guidelines
This position is full-time (40 hours/week) Monday - Saturday. Employees are required to have flexibility to work any of our 8 hour shift schedules during our normal business hours of 7:00am - 10:00pm AST. It may be necessary, given the business need, to work occasional overtime or weekends. Our office is located in the Montehiedra area in San Juan.
All new hires will be required to successfully complete Pharmacy Operations training classes and demonstrate proficiency of the material.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Valid, unrestricted Puerto Rico Pharmacy Technician license or National Pharmacy Technician Certification (PTCB), or ability to obtain license within 6 months of hire
- Proficiency with computer and Windows PC applications including ability to navigate and learn new and complex computer system applications
- Ability to identify problems including complex issues and determine solutions, both independently or in a team/group setting
- Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed
- Professional proficiency in both English and Spanish. Please note that an English proficiency assessment will be required for his position
- 1+ year experience providing customer service and working with healthcare professionals
- 1+ year of pharmacy related experience (includes retail pharmacy experience)
- Communication skills including the ability to consult/advise, demonstrate empathy, and provide clear instructions or directions
Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Pharm PA, Prior Authorization Technician, Pharmacy, Prior Authorization, Puerto Rico, Pharmacy Technician, San Juan, PR, Customer Service