Senior Retail Medication Prior Authorization Coordinator

About the role

The Senior Retail Medication Prior Authorization Coordinator is responsible for reviewing and processing requests for prior authorization of medication in accordance with insurance provider guidelines. This role requires a solid understanding of healthcare insurance policies, pharmacy benefit management, and medical terminology.

Responsibilities

• Acquire and maintain a working knowledge of health plan formulary and authorization requirements
• Utilize internal system to facilitate faster turnaround time on a complete authorization
• Gather necessary information from chart review to submit prior auth request to insurance providers
• Act as a liaison between providers, pharmacy, health plans and patients to support a timely medication authorization process
• Communicate with providers, pharmacy, and patients to provide updates on the status of their prior auth request
• Document in the patient electronic health record all medication authorization work provided following standard work guidelines
• Provide and document in Epic medication authorization denials and health plan recommendation and or alternatives when provided
• Ensure compliance with all relevant laws, regulations, and policies related to medication prior authorizations
• Perform other duties as assigned

Requirements

• High School Diploma/GED
• 1+ years of Pharmacy Technician or a Medical Assistant experience OR 1+ years of experience in a pharmacy setting
• 1+ years of experience with basic computer software and keyboarding
• Must reside within a commutable distance to Everett and surrounding communities in Washington
• Access to a designated quiet workspace in your home (separated from non-workspace areas) with the ability to secure Protected Health Information (PHI)
• Live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

Qualifications

• Current certification from WA State Department of Health as a Certified Medical Assistant or WA State Pharmacy Technician License
• Knowledge of EMR (EPIC)
• Proficiency with keyboarding, documentation, and processing prior authorizations

Skills

• Ability to work independently and maintain good judgment and accountability
• Demonstrated ability to work well with health care team
• Strong organizational and time management skills
• Ability to multi-task and prioritize tasks to meet all deadlines
• Ability to work well under pressure in a fast-paced environment
• Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying information in a manner that others can understand, as well as ability to understand and interpret information from others

Benefits

• Competitive base pay
• Full and comprehensive benefit program
• Performance rewards
• Career development opportunities
• Flexible work schedule
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401(k) contribution

Pay

The hourly pay for this role will range from $20 - $36 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Schedule

Monday-Friday, 8am-5pm PST

Location

Onsite for training at 7600 Evergreen Way, Everett WA for about 1-3 month training period and then will become fully remote. Candidates must reside near Everett, WA or must be willing and able to commute to the Everett office at their own expense for training

Reasons to consider working for UnitedHealth Group

• Competitive base pay
• Full and comprehensive benefit program
• Performance rewards
• Career development opportunities
• Flexible work schedule
• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401(k) contribution