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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


Job Category:




Approximate Salary:

Not Specified

Position Type:

Full Time

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Specialty Care Coordinator - Lake Mary, FL

UHG - Lake Mary, Florida

Posted: 11/12/2018

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, and Performance.

The employee will be part of a call center team responsible for direct communication with team members, patients and health care providers to ensure prompt processing and delivery of prescriptions. The employee will need to manage both people and processes ensuring that service levels are achieved and internal as well as external customer expectations are not only met, but surpassed on a consistent basis.  This position requires superior customer service skills, exemplary communication skills, critical thinking and problem solving skills. 

Primary Responsibilities: 

  • Promptly and accurately does benefits investigations
  • Highlights any important notes / requests from the provider in the case
  • Prioritizes and organizes cases to be processed in timely manner proportionate with the need by date
  • Accurately enters orders into the pharmacy system
  • Verifies validity of prescriptions and documents verification per company procedures
  • Contacts the physician’s office to communicate clinical information when needed
  • Notifies pharmacist of relevant clinical information gathered during calls to provider or patient that may affect the patient’s decease state or medication regimen
  • Verifies secondary insurance with each prescription that requires billing a secondary plan
  • Forwards cases to Financial Assistance Team if financial assistance is needed
  • Notify Pharmacist to transfer prescriptions that can no longer be filled at AOS / Avella to appropriate pharmacy along with notifying the provider and the patient. Follow up with transfer until a resolution is reached
  • Works with physician offices to facilitate the process of obtaining prior authorization from third party payers in order to maximize patient’s access to treatment
  • Monitors, follows up with and records all pending insurance prior authorizations to expedite processing time
  • Contacts patients to arrange delivery of medication; verifies delivery address and collect payment information
  • Offers the patient a consultation from a pharmacist
  • Answers telephones and takes messages for patient refill requests and related pharmacy business
  • Checks voicemails on assigned days
  • Reports all customer complaints to a supervisor and allows the supervisor to rectify the situation with the complainant
  • Helps to maintain the pharmacy in a clean and orderly condition
  • Provides excellent customer service to all patients and medical professionals via phone, written communication or in person
  • Maintains a collaborative approach with members of the Avella team
  • Demonstrates the utmost sensitivity and confidentiality of information while maintaining a high level of professionalism
  • Assumes additional projects on an as needed basis
  • Direct working relationship with Store Manager, Pharmacist in Charge, Director of Pharmacy Operations and Director of Patient Financial Assistance

Required Qualifications:
  • High School Diploma / GED (or higher)
  • 1+ years of pharmacy experience
  • Prior call center experience
  • Ability to work Monday - Friday between 7:00 am - 7:00 pm
Preferred Qualifications:
  • Pharmacy Technician License in the State of Florida
Soft Skills:
  • Effective communication skills both written and verbal
  • Strong Organizational Skills
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: Florida State Pharmacy Technician License, retail pharmacy, OptumRx, Pharmacy Care Coordinator

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