About the Company
OptumRx, a UnitedHealth Group company, is a leading pharmacy benefit manager (PBM) committed to helping millions of Americans access more affordable and effective pharmacy care. We leverage cutting-edge technology and innovative solutions, including robust SaaS platforms, to streamline pharmacy services, improve health outcomes, and enhance the overall patient experience. Join a team dedicated to making healthcare simpler and more efficient.
Job Description
We are seeking a highly motivated and detail-oriented Prior Authorization Pharmacy Tech with a strong focus on SaaS platforms to join our innovative team in Lancaster, PA. In this crucial role, you will be instrumental in processing prior authorization requests for prescription medications, ensuring timely approvals, and leveraging our advanced SaaS-based systems to optimize workflows and enhance efficiency. This position requires a strong understanding of pharmacy operations, medical terminology, and a keen ability to navigate and utilize sophisticated software solutions to manage and track authorizations.
Key Responsibilities
- Process prior authorization requests for prescription medications accurately and efficiently, utilizing designated SaaS platforms.
- Communicate effectively with prescribers, pharmacies, and insurance providers to gather necessary information and facilitate authorization approvals.
- Interpret and apply clinical criteria, plan benefits, and regulatory guidelines to prior authorization submissions.
- Document all interactions and prior authorization activities meticulously within the SaaS system.
- Collaborate with pharmacists and clinical teams to resolve complex prior authorization cases.
- Identify and report system issues or areas for process improvement within the SaaS platform to enhance operational efficiency.
- Maintain strict confidentiality and adhere to all HIPAA regulations and company policies.
- Provide exceptional customer service and support to all stakeholders involved in the prior authorization process.
Required Skills
- High School Diploma or GED
- Active Pharmacy Technician license/registration in Pennsylvania (or ability to obtain within 90 days of hire)
- Minimum of 1 year of experience in a pharmacy setting, preferably with prior authorization experience
- Proficiency in using software applications and navigating complex computer systems; experience with SaaS platforms is a plus
- Excellent verbal and written communication skills
- Strong attention to detail and organizational abilities
- Ability to work independently and as part of a team in a fast-paced environment
Preferred Qualifications
- Certified Pharmacy Technician (CPhT) certification
- Experience with specific prior authorization software or PBM-specific systems
- Associate's or Bachelor's degree in a related field
- Knowledge of medical terminology and drug classifications
Perks & Benefits
- Comprehensive health, dental, and vision insurance
- 401(k) retirement plan with company match
- Paid time off and company holidays
- Tuition reimbursement and continuing education opportunities
- Employee assistance program
- Opportunities for career growth and professional development within a leading healthcare organization
How to Apply
If you are interested in this position, please click the "Apply Now" button below. To ensure your application is properly considered, please prepare the following:
- An up-to-date Resume or CV
- A brief cover letter summarizing your experience and motivation
Applications are reviewed on a rolling basis. Only shortlisted candidates will be contacted for an interview.
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