UnitedHealth Group is among the most ambitious Fortune 25 companies you'll ever meet. Through our family of businesses, we're working to make the health care system perform better for more people, in more ways than ever.
Simply put, we think the entire system can be greater than it's ever been. And that drives us to work harder, aim higher, and expect more from one another.
Here, you'll be empowered to make an immediate impact for millions of others. And you'll achieve more than you ever expected. How does that fit with your plans?
Pharmacist (Prior Authorization) for Costa Mesa-314845
UnitedHealth Group is an innovative leader in the health and well-being industry, serving more than 55 million Americans. Through our family of companies, we contribute outstanding clinical insight with consumer-friendly services and advanced technology to help people achieve optimal health.
Description Prescription Solutions helps consumers obtain the medications and products they need to live healthier lives. Services offered by the company include pharmacy network contracting, rebate contracting and administration, mail order pharmacy facilities, specialty drugs and retail drug claims processing. The company is one of only three in the United States to have received URAC dual accreditation and provides clinical services to help its clients provide cost effective, quality-driven results.
The company is part of Pharmacy Services group, within Enterprise Services, a family of UnitedHealth Group businesses dedicated to improving the health and well-being of Americans.
Primary Responsibilities: Clinical Pharmacist working in the Prior Authorization unit within Customer Service department of Prescription Solutions. Primary role is reviewing Prior Authorization cases and rendering coverage determinations based on clinical criteria and plan design. Consult physicians with questions and interpretations of clinical guideline criteria and coverage determinations rendered. Participate in inter-department meetings with the Clinical Services & Client Management teams of Prescription Solutions. Participate and contribute to Prior Authorization clinical medication guideline development and revision process. Participate in quality improvement and process enhancement projects as assigned by management. Qualifications
- Active CA pharmacist license to practice without restriction
- 1-3 years practicing pharmacist experience
- Strong drug product and clinical pharmacy knowledge
- Computer proficiency required including MS Office applications (Word, Excel, PowerPoint, Outlook, etc.)
- Excellent written and oral communication skills
- Excellent interpersonal and problem-solving skills
- Strong customer service orientation and commitment to professionalism
- Demonstrated ability to work independently with minimal supervision
Preferred Assets:
- 1-3 years pharmacist experience working in a clinical pharmacy practice setting
- Pharm.D degree
- Completion of Pharmacy Residency
- Experience working with a PBM company or managed healthcare system
- Experience developing or operationalizing medication clinical guidelines and/or formulary development
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. In addition, employees in certain positions are subject to random drug testing.
Diversity creates a healthier atmosphere: equal opportunity employer M/F/D/V. UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. |
