Pharm PA/Appeals Technician
Philadelphia, PA 
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Posted 5 days ago
Job Description

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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.

The Pharmacy PA/Appeals Technician will be responsible for understanding the requirements and deliverables of the state Medicaid contracts that fall under their Account Managers purview and serving as a key staff member responsible for working with the Account Manager to ensure duties and tasks are met in a timely manner.

The Pharmacy PA/Appeals Technician will assist the Account Manager with all non-clinical duties, tasks, and contract requirements and services for several states Medicaid Drug Utilization Review Boards, Pharmacy & Therapeutics Committees, weekly drug files, and other duties. In addition, this position will assist with all non-clinical duties, tasks, and all contract requirements for the specific states Retro Drug Utilization Review Program.

The Pharmacy Account Coordinator shall be available to the Medicaid departments during regular working hours and shall be dedicated to the Medicaid Programs mentioned above.

You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Administrative services related to Preferred Drug List (PDL), Supplemental Rebate (SR), State Maximum Allowable Cost (SMAC), RetroDUR, file transfers and maintenance, preparation of weekly drug file, and maintenance for preferred drug list including budgetary and clinical reports
  • Assists with Coordination and Support of P&T or other Committee activities including tracking status of documentation, gathers and prints materials, assembles, and ships materials, brings required reports (e.g., cost sheets, PDL compliance reports and generic percent reports to the P&T Meeting), and prepares drafts of the minutes and circulates for review. Also assists with post-P&T Committee Meeting updates and communication
  • Prepares and develops minutes of client status meetings (frequency as required by contract and/or customer needs)
  • Has a working knowledge of federal and state specific Medicaid Pharmacy Policy and regulations, PDL/Point of Sale (POS) rules and suggesting enhancements and/or changes
  • Assists with operations of any contractual duties for respective Medicaid state contracts, including SLAs and deliverables
  • Assists with fiscal operations where applicable
  • Provides audit support and documentation for several audits, including internal and external (State IT audit, State internal audit, etc.)
  • Assists with Monthly, Quarterly, Annual, and ad hoc reports that need to be validated prior to delivery
  • Maintains deliverables for the timely submission of reporting, training material, and business processes as they relate to contract requirements

What are the reasons to consider working for UnitedHealth Group?

  • 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
  • Flexible Work Arrangement
  • Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)
  • More information can be downloaded at: http://uhg.hr/uhgbenefits

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:

  • Active & current Pharmacy Technician license in state of residence
  • 2+ years of experience working in a pharmaceutical setting
  • Ability to work Monday - Friday, 9am - 5pm EST

Preferred Qualifications:

  • Pharmacy Technician License in state of West Virginia or Pennsylvania
  • National Pharmacy Technician Certification (PTCB)

Soft Skills:

  • Candidate should be detail oriented, organized, have effective communication skills, be client-oriented and have the ability to multi-task

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

California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island, Hawaii or Washington Residents Only: The hourly range for California, Colorado, Nevada, Connecticut, New York, New Jersey, Rhode Island or Washington 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.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

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.

#RPO, #GREEN

 

Job Summary
Company
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Experience
2+ years
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