Prior Authorization Supervisor - Costa Mesa, CA - Full-time / Part-time

When
you are in the business of health care, you're in the business of
people. At UnitedHealth Group we want every customer experience to be
distinctly personal. The challenge is complex. When people call us for
help, their focus is on getting the best care possible. We help them
understand their benefits and their options. This part of their lives
matters a lot to them and it matters just as much to us. Our customer
service teams have a serious responsibility to make every contact
informative, productive, positive, and memorable for what it says about
how much we care.

The
essential functions of a pharmacy technician in Prior Authorization are
providing expertise and customer service support to members, customers,
and/or providers. This position exists to take incoming requests for
prior authorizations, for formulary and non formulary medications, while
ensuring a high level of customer service and maximizing productivity.
Request can be received via fax or telephone, from providers' offices
and pharmacists. The position provides clinical review for
authorizations in keeping with legal and contractual requirements,
including but not limited to turn around times (TATs) and service level
agreements (SLAs). The technician must provide the information clearly,
accurately and in a professional manner. Interactions with callers must
be documented per contractual and various regulatory / legal
requirements.

Positions
in this function are responsible for providing expertise and customer
service support to members, customers, and/or providers. Direct
phone-based customer interaction to answer and resolve a wide variety of
inquiries.

Primary Responsibilities:

• Coordinates, supervises and is accountable for the daily/weekly/monthly activities of a team members
• Sets
  priorities for the team to ensure task completion and performance goals
  are met, such as Quality, Adherence, Service Level and AHT
• Coordinates work activities with other supervisors, managers, departments, etc
• Identifies and resolves operational problems using defined processes, expertise and judgment
• Provides coaching and feedback to team members, including formal corrective action
• Conducts annual performance reviews for team members
• Provides expertise and customer service support to members, customers, and/or providers
• 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
• Answer
  prior authorization inquiry calls or/and faxes as well as research and
  resolve formulary and benefit issues using the appropriate reference
  material
• Resolve issues and complaints in a timely manner
• Performs other duties as assigned by management
• Handles inbound phone requests and gathers member data to provide information for Pharmacist consultations
• Coordinates, supervises and is accountable for the daily activities of business support, technical or production team or unit
• Impact of work is most often at the team level