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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us in making healthcare work better for everyone through people-led, responsible AI while Caring. Connecting. Growing together

Optum Puerto Rico Operations is creating an innovative approach to Pharmacy Benefit Management. As a Pharmacy Technician - Prior Authorization, you will be answering incoming calls, completing outbound calls to/from patients, physicians and pharmacists while ensuring a high level of customer service and maximizing productivity.

This role is equally challenging and rewarding. You will help identify problems and determine solutions both independently and, in a team/group setting. You'll need to work within multiple computer systems simultaneously as you respond to questions or provide specific medication details/clinical information. It's a fast paced, high-volume environment where accuracy is essential.

Primary Responsibilities:

• Receive member and provider calls
• Process prior authorizations through various computer systems ensuring the accuracy of all data and updating as necessary through inbound calls
• Navigate across multiple computer systems to respond to questions or to provide specific medication details/clinical information
• Receive incoming calls from members or providers and conduct outgoing calls as needed to provide follow-up or consultation such as prior authorization requirements, appeals, etc.
• Apply benefit plan criteria when making decisions (approvals/denials) or recommendations
• Provide members with general benefit information
• Partner with others to gather additional information and/or to interpret clinical guidelines

*** ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION ***

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:

• Valid, unrestricted Puerto Rico Pharmacy Technician license or the Pharmacy Technician Certification Board
• Proficiency with computer and Windows PC applications including ability to navigate and learn new and complex computer system application
• Proven ability to identify problems including complex issues and determine solutions, both independently and in a team/group setting
• Professional proficiency in both English and Spanish (English proficiency assessment will be required for this position)
• Available for 8 weeks of on-site process training
• Ability to work 40 hours/week during standard business operating hours Monday - Friday from 8:00am - 10:00pm AST and Saturdays from 9:00am - 7:00pm (It may be necessary, given the business need, to work occasional overtime on weekends and holidays)

Preferred Qualifications:

• Experience providing customer service and working with healthcare professionals
• Experience in a pharmacy related role (includes retail pharmacy experience)
• Demonstrated communication skills including the ability to consult/advise, demonstrate empathy, and provide clear instructions or directions

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.