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.
Positions in this function consult with customers, members, patients, providers, internal departments and / or external third parties on any or all of the following:- Consult with and coordinate initial set up and on-going treatment plan for specialty drug patients, including DURs, co-pay assistance, ancillary products, scheduling Pharmacist consults and / or RN visits, and liaison with provider offices on labs, refill orders and prior authorizations.
- Responsible for running test claims, documenting and submitting therapy based drug prior authorizations to benefit plans, proceeding with referrals when approved or denied, communicating with patients, physicians, and account managers
- Responsible for monitoring assignments on the provider advocate dashboard to keep referrals progressing
- Review and advise on medications and treatment plans (based on review of medical case notes, medication list and lab results) to improve outcomes and avoid potential drug interactions
- Discuss with patients life issues affecting medication adherence and provide advice on improving drug regimen compliance
- Advise patients on alternate Rx fill strategies of retail versus mail order and options for financial assistance
- May outreach to providers on suspected medication abuse situations.
- Review medication regimen for disease state for LTC facilities/ hospice care / RN case managers / Medical Directors / clients and provide summaries and guidance on future medication plans. Advice may include alternate drug therapies, stopping a medication and/or lower cost alternative.
- Review medical case notes to determine on-going medication treatment plan and project future medication costs
- 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
- High School Diploma / GED (or higher)
- 2+ years of pharmacy experience
- Pharmacy Prior Authorization experience
- Pharmacy Technician License in the State of Tennessee
- Effective communication skills both written and verbal
- Strong Organizational Skills
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.