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UnitedHealth Group Pharmacy Navigator - Remote in Worcester, MA in Worcester, Massachusetts

6 Weeks On-Site Training in Worcester, MA

Opportunities with Reliant Medical Group , part of the Optum family of businesses. Join a community-based, multi-specialty, physician-led organization where you will work with talented peers on a common purpose: improving the quality, cost and experience of health care. Here, we focus on delivering the best patient care, rather than volume. Through innovation and superior care management, we support patients and your well-being as a team member. Join a team at the forefront of value-based care and discover the meaning behind Caring. Connecting. Growing together.

Position in this function provides operational support to the Prescription department location. Receives requests to process prescriptions in an accurate and timely manner to get providers approval. Performs assigned prescription functions and duties in support of the prescription department. Takes incoming calls and make outreach telephone calls to patients who have requested medication refills or renewals. Processes medication requests following standard procedure. Checks appropriate notes, pertinent lab results and order labs that are required to support requests being pended for provider approval. Checks if patients are up to date with appointments and books follow up appointments that are required to sustain compliance with treatments. Selects and pend correct medication, dosage, sig and number of refills with selecting correct pharmacy before routing to the appropriate provider for approval. Manages patient’s drug management agreements and updates accordingly. Processes prior authorizations for medications that are not covered by patients’ insurance. Performs tasks focused on fostering teamwork and dedication to patient safety and satisfaction.

Work Schedule: Monday – Friday 8:30am – 5pm EST or 10:30am – 7:30pm EST based on business needs. On site 6-week training, must be in Worcester, MA.

If you are located in Massachusetts, New Hampshire, Rhode Island, or Connecticut, you will have the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Performs assigned duties as directed by the prescription specialist supervisor

  • Interacts effectively and professionally with all location departments at Reliant Medical Group

  • Interacts effectively and professionally with all patients, prescribers and payors and pharmacies related to any and all prescription requests

  • Develops proficiencies in utilization of Epic

  • Works independently and handles multiple tasks

  • Greets patients over the telephone to ensure prompt service for patient needs

  • Performs computer entry of prescription information including but not limited to patient search, prescriber search, drug selection, prescription interpretation, chart review, and provides accurate documentation in Epic

  • Accurately reviews and processes e-prescriptions, faxed prescriptions, my-chart renewals, patient calls per Prescription Department guidelines

  • Accepts customer, insurance and prescription information required to process new and refill prescriptions, including refill authorization from doctor offices where permitted by state law

  • Communicates any issues which may delay the prescription to the patient. Works directly with the prescription specialist supervisor to coordinate the resolution for the patient

  • Assists with maintaining the prescription pool by keeping it up to date and while also managing open encounters and in-basket management

  • Follows all asset protection and personal safety guidelines as outlined in the department Policy and Procedures

  • Responsible for obtaining correct Prior Authorizations forms. Completes and processes prior authorizations for medications that are not covered by patient’s insurance

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

Required Qualifications:

  • High School Diploma/GED (or higher)

  • Current unencumbered Pharmacy Technician license in the state of Massachusetts

  • 1+ years of retail Pharmacy Technician experience

  • Ability to work alternate shifts including 7:00am-3:30pm, 8:30am-5:00pm, and 10:30am-7:00 pm

  • Ability to work onsite for 6 weeks of initial training at our Worcester, MA office

Physical Requirement:

  • 1+ years of prior authorization experience

  • Physical health sufficient to meet the ergonomic standards and demands of the position

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

Connecticut or Rhode Island Residents Only : The hourly range for Connecticut or Rhode Island residents is $16.00 to $28.27 per hour. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with UnitedHealth Group, you’ll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

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.