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in Waltham, MA

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Hours Full-time, Part-time
Location Waltham, MA
Waltham, Massachusetts

About this job

Position Description:As one of the largest pharmacy benefits managers in the United States, UnitedHealth Group provides a professional culture where you're empowered and encouraged to exceed the expectations of our members, with better schedules than retail and more reach than any hospital. Join us and start doing your life's best work.Primary Responsibilities: Troubleshooting issues within the health planAssisting Case Managers on an individual member basis by working through the member’s pharmacy - related barriersProviding support to the Pharmacy DirectorConducting basic reporting and analysisResearching member or physician concerns by assisting pharmacies in claims adjudication and prescriber coordinationProactive identification and intervening on behalf of members at - risk who are not already in case managementExpand provider educational efforts via individual and mass communication as negative trends are identified.Support member education by improving pharmacy - related health literacy with benefit navigation assistance may be telephonic or in person.Reviews and approves / denies requests for prescription prior authorizations.Pharmacists must have a current license without restrictions and Pharmacy Technicians must have current state license or national certification without restrictions based on regulatory requirements of work site. Extensive work experience, possibly in multiple functions.Work does not usually require established procedures.Works independently.Mentors others.Acts as a resource for others.Coordinates others' activities.

Requirements

Requirements:High School Diploma / GED OR 5+ years of equivalent work experience.Pharmacy Technicians must have current state registration or license and national certification without restrictions based on regulatory requirements of work site3+ years of Pharmacy related experienceExperience using Windows PC applicationsAvailable to work Monday - Friday 8:00 AM - 4:30 PMAssets:Managed Care experienceSoft Skills:Ability to learn new and complex computer system applicationsCareers with UnitedHealthcare. Let's talk about opportunity. Start with a Fortune 14 organization that's serving more than 85 million people already and building the industry's singular reputation for bold ideas and impeccable execution. Now, add your energy, your passion for excellence, your near - obsession with driving change for the better. Get the picture? UnitedHealthcare is serving employers and individuals, states and communities, military families and veterans where ever they're found across the globe. We bring them the resources of an industry leader and a commitment to improve their lives that's second to none. This is no small opportunity. It's where you can do your life's best work.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.Keywords: Insurance, customer service, customer service representative, claims, appeals, call center, phone support, dispute resolution, healthcare, UnitedHealthcare, UnitedHealth Group, OptumRX, pharmacy, pharmacy technician, prescription, Pharm Tech, Licensed Pharm Tech, Pharmacy Clerk, Pharm Clerk