Lead Pharmacy Technician - Any UHC Corporate Office - Full-time / Part-time

• Under supervision of a Pharmacist or other clinical staff, triage of all medical and specialty drug preauthorization requests, including prioritization of reviews, case preparation, documentation tracking and organization, case review using SOPs and guidelines within the regulatory maximum turn-around time and, where appropriate, coordinate escalation for pharmacist review.  
• Support end-to-end process for drug preauthorization reviews including collaboration with National Intake, operations, case management, ancillary care management, compliance, benefits and eligibility, National Letters team, and other departments as necessary.
• Handles incoming calls and faxes to department and communicates clearly and efficiently with physicians, pharmacies and members. Provides superior customer service.
• For approval determinations and additional information requests, compile and edit letter contents using existing templates and systems, provide appropriate attachments, mail and/or fax determination letters to physician(s), specialty pharmacy(s) and member. Provide clear, concise verbal feedback to physician(s), specialty pharmacy vendor(s), and member(s) as required.
• Tracks work flows consistent with pharmacy  P& P's particularly case volume and turn-around times, to meet regulatory and accreditation requirements
• Monitors and reports results and defines and implements corrective action, if required
• Responsible for retaining all printed documents as required by corporate policy, including coordinating off site storage, indexing, retrieval during the retention period and destruction when retention period completed.
• Participate in ongoing process review to ensure improvements in operational processes.
• Other responsibilities as assigned

• High school diploma/GED or 10 years of work history
• Work Hours Monday – Friday 8:30am – 5:30pm CST- with flexibility to work later hours as needed
• Valid and active Pharmacy Technician registration (state or national)
• Knowledge of Claims Adjudication
• Good knowledge of drugs and drug classes that are administered by injection or infusion
• Ability to navigate and utilize multiple clinical data management systems at the same time (i.e. Health Plan and PBM)
• Understanding of medical terminology to interpret clinical records
• Understanding of ICD-9/ICD-10, J codes, other  drug and drug administration related CPT and HCPC Codes
• Strong Microsoft office skills, including Intermediate level in MS Word, Excel, Internet and Intranet functions and data tracking applications

• Knowledge of medical and pharmacy benefit design
• Experience as a Military Corpsmen
• 1+ year of experience as a Paramedic OR EMT

• Ability to work in fast pace environment and manage multiple deadlines while adhering to compliance regulations

Diversity creates a healthier atmosphere: 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.