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Job Information

UnitedHealth Group Senior Pharmacy PA / Appeals Technician - Remote Nationwide in Cypress, California

Energize your career with one of Healthcare’s fastest growing companies.

You dream of a great career with a great company – where you can make an impact and help people. We dream of giving you the opportunity to do just this. And with the incredible growth of our business, it’s a dream that can come true. Already one of the world’s leading Healthcare companies, UnitedHealth Group is restlessly pursuing new ways to operate our service centers, improve our service levels and help people lead healthier lives. We live for the opportunity to make a difference and right now, we are living it up.

This opportunity is with one of our most exciting business areas: Optum – a growing part of our family of companies that make UnitedHealth Group a Fortune 5 leader.

Optum helps nearly 60 million Americans live their lives to the fullest by educating them about their symptoms, conditions and treatments; helping them to navigate the system, finance their healthcare needs and stay on track with their health goals. No other business touches so many lives in such a positive way. And we do it all with every action focused on our shared values of Integrity, Compassion, Relationships, Innovation & Performance.

Positions in this function prep, review and approve / deny requests for prescription prior authorization and / or appeal. Clerks scan, index and prepare documents related to prior authorization and / or appeal request, verifying and updating patient / member profile information. Techs and Pharmacists compile medical notes (disease state, drug treatment history and current drug plan) from patient / provider in support of the request, review request against decision tree and approval protocol, perform outreach for additional information as needed to support the request. Update approved requests in claims systems and inform patient / provider of approval. Forward applicable requests through additional review path as needed. Ensures Rx denial is communicated to patient/provider along with rationale.

You’ll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Extensive work experience within own function

  • Work is frequently completed without established procedures

  • Works independently

  • May act as a resource for others

  • May coordinate others' activities

  • Requires current pharmacy technician state license or national certification without restrictions based on regulatory requirements of worksite

  • Extensive work experience within own function

  • Work is frequently completed without established procedures

  • Works independently

  • May act as a resource for others

  • May coordinate others' activities

  • Extensive work experience within own function

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.

Required Qualifications:

  • High School Diploma / GED (or higher)

  • Pharmacy Technician License in state of residence

  • 1+ years of pharmacy / prescription data entry experience

  • Ability to work a flexible schedule Monday - Friday 6:00 am - 6:00 pm

Preferred Qualifications:

  • National Pharmacy Technician certification (PTCB)

  • Proficiency with computer and Windows PC applications including ability to navigate and learn new and complex computer system application

Careers with Optum. We built an entire organization around one giant objective; make the health system work better for everyone. 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 an elite team. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.

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