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We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM


Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com


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Pharmacist PA / Appeals - Cypress, CA

UHG - Cypress, California

Posted: 10/20/2018

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 definitely 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 6 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.

Position Description:
  • Review Prior Authorization cases and render coverage determinations based on clinical criteria and plan design in a fast paced and dynamic environment
  • Work is computer based and may include receiving phone calls from Prior Authorization Pharmacy Technicians and / or providers where clinical information is involved
  • Consult physicians / providers with questions and interpretations of clinical guideline criteria and coverage determinations that have been rendered
  • Participate in quality improvement and process enhancement projects as assigned by management
  • Consult with PA technicians and / or physicians regarding use of medications and advise of appropriate formulary alternatives when requested
  • Build rapport with coworkers, internal customers, and other departments by demonstrating a strong customer service orientation and a continuous positive image of OptumRx
  • Demonstrate ability to maintain productive working relationships with team members, other internal and external customers, and management team
  • Perform other duties as required

Required Qualifications:
  • BS in Pharmacy or Pharm D Degree
  • Pharmacist license in good standing in the State of California
  • Strong drug product and clinical pharmacy knowledge
  • Ability to work (an 8-hour shift) within the hours of 9:00am to 7:00pm Monday - Friday, including Saturdays and/or Sundays by rotation
  • Ability to work overtime based on the needs of the business
Preferred Qualifications: 
  • 1+ years of practicing Pharmacist experience
  • 1+ years of Pharmacist experience working in a clinical pharmacy practice setting
  • Experience developing or operationalizing medication clinical guidelines and/or formulary development
  • Experience working with a PBM company or managed healthcare system

OptumRx is an empowering place for people with the flexibility to help create change. Innovation is part of the job description. And passion for improving the lives of our customers is a motivating factor in everything we do.


If you're ready to talk about groundbreaking interactions, let's talk about what happens when a firm that touches millions of lives decides to gather results from millions of prescriptions every month and analyze their impact. Let's talk about smart, motivated teams. Let's talk about more effective and affordable healthcare solutions. This is caring. This is great chemistry. This is the way to make a difference. We're doing all this, and more, through a greater dedication to our shared values of integrity, compassion, relationships, innovation and performance.  Join us and start doing your life’s best work.

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.

Keywords: Pharmacist, PA, Appeals, Cypress, CA

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