Senior Pharmacy Technician for Prior Authorization and Appeals - Remote Opportunity with Optum

Transform Healthcare with Optum: Join Our Team as a Senior Pharmacy Technician

At Optum, a global leader in health services, we're driven by a mission to help millions live healthier lives. Leveraging technology, data, and expertise, we connect people with the care, resources, and support they need to thrive. As a Senior Pharmacy Technician for Prior Authorization and Appeals, you'll be at the forefront of this mission, delivering exceptional customer service, clinical expertise, and operational efficiency to members, customers, and healthcare providers.

About the Role

This remote position is a key part of Optum's Prior Authorization team, where you'll process incoming requests for medication authorizations, ensuring compliance with legal, contractual, and regulatory requirements. Your expertise will directly impact health outcomes, making a tangible difference in the lives of those we serve.

Key Responsibilities

• Handle a high volume of prior authorization calls (up to 50-70 per day) from providers and members, providing timely and accurate support.
• Research and resolve formulary and benefit issues using various reference materials, ensuring informed decision-making.
• Process authorizations through multiple computer systems, maintaining data accuracy and integrity.
• Document caller interactions in accordance with contractual and regulatory requirements, ensuring transparency and compliance.
• Conduct clinical reviews for authorizations, adhering to legal and contractual standards.
• Resolve issues and complaints efficiently, demonstrating a customer-centric approach.
• Perform additional tasks as assigned by management, showcasing flexibility and adaptability.
• Gather member data to facilitate pharmacist consultations, contributing to comprehensive care.

Essential Qualifications

To excel in this role, you'll need:

• Active and unrestricted licensure/certification as a Pharmacy Technician, such as PTCB, State Board of Pharmacy Licensure, ExCPT with NHA, or certification as a Prior Authorization Specialist.
• A minimum of 6 months' experience in customer service or customer relations, preferably within a healthcare setting.
• Basic proficiency in Microsoft Office applications, including Excel, Word, and Outlook.
• Flexibility to work varied shifts within the 5:00 AM to 12:00 AM timeframe, including weekends and potential overtime.

Preferred Skills and Qualifications

While not mandatory, the following attributes can enhance your candidacy:

• Familiarity with call center systems, such as IEX, can streamline your workflow.
• Strong written and oral communication skills are crucial for achieving high Net Promoter Survey (NPS) scores.
• A track record of task completion and follow-through demonstrates reliability and accountability.

Career Growth and Development

At Optum, we're committed to your professional growth and development. As a Senior Pharmacy Technician, you'll have opportunities to:

• Expand your clinical knowledge and expertise in prior authorization and appeals.
• Develop your customer service and communication skills, driving positive outcomes.
• Enhance your technical skills, navigating complex systems and technologies.
• Advance your career within Optum, exploring new roles and challenges.

Work Environment and Culture

As a remote employee, you'll enjoy the flexibility of working from home while being part of a dynamic, global team. Optum prioritizes:

• Diversity and inclusion, fostering a culture of respect and empathy.
• Comprehensive benefits and wellness programs, supporting your overall well-being.
• Career development and growth opportunities, empowering you to succeed.
• A collaborative, supportive work environment that encourages innovation and teamwork.

Compensation and Benefits

Optum offers a competitive compensation package, including:

• A salary that reflects your experience and qualifications.
• Paid Time Off and 8 Paid Holidays, plus a Floating Holiday.
• Medical, Dental, Vision, Life, and AD&D Insurance, along with Short-term and Long-Term Disability coverage.
• A 401(k) Savings Plan and Employee Stock Purchase Plan.
• Education Reimbursement and Employee Discounts.
• An Employee Assistance Program and Employee Referral Bonus Program.
• Flexible Work Arrangements and Voluntary Benefits, such as pet insurance and legal insurance.

Join Our Team

If you're passionate about delivering exceptional healthcare support and are looking for a challenging, rewarding role, we encourage you to apply. Even if you don't meet every qualification, we'd love to hear from you. At Optum, we're committed to finding talented individuals who share our mission and values.

Take the first step towards a fulfilling career with Optum. Apply now to become a Senior Pharmacy Technician for Prior Authorization and Appeals, and join our mission to advance health equity on a global scale.