AmeriChoice is part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system.
If you're ready to help make health care work better for more people, you can make a historic impact on the future of health care at AmeriChoice.
We contract with states and other government agencies to provide care for over two million individuals. Working with physicians and other care providers, we ensure that our members obtain the care they need with a coordinated approach.
This enables us to break down barriers, which makes health care easier for our customers to manage. That takes a lot of time. It takes a lot of good ideas. Most of all - it takes an entire team of talent. Individuals with the tenacity and the dedication to make things work better for millions of people all over our country.
Primary Responsibilities:
- Regular attendance is a fundamental job requirement.
- Satisfy and maintain pharmacy department quality and quantity objectives and standards.
- Answer provider telephone calls concerning pharmacy adjudication issues, provider questions concerning formulary, plan benefits and eligibility.
- Answer Health Plan Pharmacy related questions for internal customers on the ACD queue line
- Make outbound calls to pharmacy and providers
- Processing of medical exceptions and prior authorization requests by entering related data into a computerized database.
- Enter medication approvals into a PBM system
- Meet demanding deadlines and utilize sound judgment while functioning independently on a technical level.
- Perform clerical functions of the department including faxing to physicians and communicating via the telephone in a professional manner to convey messages to retail pharmacists and other professional office staff.
- Work "on call" shifts as scheduled.
- Comply with HIPAA requirements
- Other duties may be assigned
You can be a part of this team. You can put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered.
