Senior Pharmacy PA​/Appeals Technician

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Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

If you currently reside in the state of Vermont, you'll enjoy the flexibility to telecommute
* as you take on some tough challenges.

Ability to work any shift from 5:00 AM to 12:00 AM timeframe with flexible hours, including OT and weekends.

• Manages a high volume of inbound and outbound calls, averaging 50+ daily
• Answering Prior Authorization inquiry calls/requests with customer service skills as well as research, clinical information system utilizations and resolve formulary and benefit issues using the appropriate reference material
• Process prior authorizations through multiple computer systems and use of job aids/policies/procedures ensuring the accuracy and compliance of all data and updating as necessary
• Resolve issues and complaints in a timely manner
• Handle inbound phone requests and gathers member data to provide information for pharmacist consultations

• Have sharp attention to detail, using established criteria and guidelines, the pharmacy technician receives, and processes prior authorization requests made by providers and members for medications not inherently covered on a member's prescription drug plan
• Performs other duties as assigned by management

• Patient Safety and Quality of work is paramount and it's important for employees to have a safe and secure workspace and communicate with their leadership when that safety (equipment, system, information) is compromised
• Promote a culture of safety that is equitable, transparent, and engaging for patients, family caregivers, and healthcare workforce
• Enhance workforce safety and well-being by mitigating physical and psychological risks, analyzing hazard data, and implementing supportive workplace strategies
• Leadership will oversee the monitoring of safety event trends, provide feedback on safety initiatives, quality improvement efforts, and governance to develop responsive measurable action plans

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
• More information can be downloaded at: (Use the "Apply for this Job" box below)./uhgbenefits

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

• Licensure Requirement - Must have one of the following active and unrestricted licensure/certifications:
  • Pharmacy Technicians Certification Board (PTCB)
  • State Board of Pharmacy Licensure in state of residence
  • ExCPT - Pharmacy Technician Certification with National Health career Association (NHA)
  • The National Board of Prior Authorization Specialist
• 6 + months of experience in customer service/customer relations with healthcare professionals
• Basic level…