UHG

About UHG

Careers at UnitedHealth Group

 

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

 

Job Category:

Pharmaceutical

Country:

US

Postal Code:

32099

Approximate Salary:

Not Specified

Position Type:

Full Time

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Senior Pharmacy PA/Appeals Technician - Jacksonville, FL

UHG - Jacksonville, Florida

Posted: 10/16/2018


Careers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 6 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near-obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, Military families and Veterans wherever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life’s best work.SM


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.


Primary Responsibilities:

  • Verify entered adjudicated prescriptions and verify appropriate and accurate information
  • Contact patients, pharmacists and doctor's offices to resolve claims issues
  • Process prescriptions (from intake to order completion)
  • Resolve customer issues; ensuring accurate information is provided


Requirements:
  • High School Diploma or GED or higher
  • 1+ years of customer service experience analyzing and solving customer problems, OR 1+ years of experience in an office setting environment using the telephone and computer as the primary instruments to perform job duties

Preferred Qualifications:

  • Associate's degree or 3+ years of equivalent work experience
  • 1+ years of previous experience as a Pharmacy Technician

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.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.

 

Keywords: Optum, Pharmacy, Appeals, Healthcare, Technician, Jacksonville

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