Prior Authorization Resolution Coordinator – Remote Nationwide

Opportunities with Genoa Healthcare.  A career with Genoa Healthcare means you’re part of a collaborative effort to serve behavioral health and addiction treatment communities. We do more than just provide medicine: we change lives for the better. People with serious mental or chronic illness – and those who care for them – have moving stories, and at Genoa we become their voice, their partner. Working as part of a coordinated care team, we partner with community-based providers and others to ensure that people with complex health conditions get the right medications and are able to follow their treatment plans. Our personalized services – in-clinic pharmacies, medication management and more – are leading the way to a new level of care. 

Genoa is a pharmacy care services company that is part of Optum and UnitedHealth Group’s family of businesses. We are part of a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Join us to start Caring. Connecting. Growing together.  

The Prior Authorization Resolution Coordinator is responsible for preparation, review and completion of requests for prescription prior resolution support. Coordinator prepares documents related to prior authorization and/or appeal requests, verifying and updating patient/member profile information. This role also compiles medical notes (disease state, drug treatment history and current drug plan) in support of the request, performs outreach for additional information as needed to support the request, and submits prior authorization(s) for approval as an agent of the physician. Update approved requests in claims systems and inform healthcare team of outcome. When applicable, the coordinator forwards applicable requests through additional review path(s) and research financial assistance programs, as needed. 

Hours: Monday-Friday 8:00am to 4:30pm or 9:00am to 5:30pm CT ( with some flexibility)

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

Primary Responsibilities: 

• Support prior authorization resolution in collaboration with Genoa Healthcare Pharmacy locations
• Initiate review and appeal process, when needed
• Aids in co-pay assistance set-up, when needed
• Manage reports to ensure all Prior Authorization requests are completed for Genoa Healthcare Pharmacy locations
• Generate reporting to monitor timely completion of prior authorizations resolution 
•  Completes administrative duties, which include processing mail and faxes, to aid in prior authorization resolution
• Research and stay up to date on insurance plan eligibility and prior authorization criteria
• Work independently to complete prior authorization needs from beginning to end and communicate with key stakeholders during the process
• Performs other projects, work, and activities as assigned to ensure continuous service to our patients and clients

What are the reasons to consider working for UnitedHealth Group?   Put it all together – competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success. Some of our offerings include:

• 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
• 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: 

• High School Diploma/GED (or higher)

Preferred Qualifications:

• 2+ years of pharmacy operations experience
• 2+ years experience with prior authorization resolution and ability to navigate associated technology and platforms
• Exceptional interpersonal and communication (verbal, listening) skills

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

   

The salary range for this role is $16.88 to $33.22 per hour based on full-time employment. 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.

    

    

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