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?
Manager, Pharmacy Operations - Pittsburgh, PA-315667
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 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.
Positions in this function perform various duties related to the oversight of the pharmacy prior authorizations process. The position manages and is accountable for professional employees and/or supervisors. Impact of work is most often at the local level.Pharmacists must have a current license without restrictions and Pharmacy Technicians must have current state license or national certification without restrictions based on regulatory requirements of worksite.
Responsibilities include:
- Assists the PNS Director with oversight of daily operations and technical personnel, with routine decisions that include staffing and workload assessments, scheduling, and candidate selection.
- Understands the Prior Auth case creation and review process.
- Consults with customers (physicians, pharmacies) regarding status of prior authorization and/or issues related to such.
- Sets team direction, resolves problems and provides guidance to members of own team.
- May oversee work activities of other supervisors.
- Adapts departmental plans and priorities to address business and operational challenges.
- Influences or provides input to forecasting and planning activities.
- Product, service or process decisions are most likely to impact multiple groups of employees and/or customers (internal or external).
- Troubleshoot issues as they arise
- Identify system and process-related changes to improve prior authorization process
- Apply knowledge/skills to complex activities, including those that may vary from day to day
- Demonstrate a depth and breadth of knowledge/skills in own area and is often able to apply these outside of own function
- Participate in the training of new and existing employees
- Routine assessment of employees for adherence to defined metrics
- Work with the Director to resolve operational issues
- Document communication activities and provide required reports
- Troubleshooting issues as they arise from physicians, pharmacies, and members
- Identify system and process-related changes to improve prior authorization process
- Apply knowledge/skills to complex activities
- Demonstrate a depth and breadth of knowledge/skills in own area and is often able to apply these outside of own function
- Often acts as a technical resource to others in own function
- Anticipate customer needs and proactively identify new solutions to problems
- Solve complex problems on own; proactively identify new solutions to problems
- Plan, prioritize, organize, and complete work to meet established objectives
- Act as a facilitator to resolve conflicts on team; seen as a key member on project teams, spanning more than own function
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. Qualifications
- Bachelors degree in Science or equivalent work experience required; Masters degree preferred
- Active Pharmacist license strongly preferred
- 5+ years operations experience or pharmacy experience in a retail, hospital or managed care pharmacy environment
- Experience working in Medicaid and/or Medicare health care and insurance industry
- 8+ years Clinical background preferred.
- 4+ years demonstrated leadership and team management/development skills
- Proficiency in software applications that include, but are not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint
- Demonstrated ability to assist with focusing activities toward a strategic direction as well as develop tactical plans, drive performance and achieve targets
- Problem solving skills; the ability to systematically analyze problems, draw relevant conclusions and devise appropriate courses of action
- Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
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. |
