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 diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together.
You're looking for something bigger for your career. How about inventing the future of health care? OptumRx is creating an innovative approach to Pharmacy Benefit Management. Here you'll find a professional culture where you can use your talent and our resources to make an impact on a huge scale. With better schedules than retail and more reach than any hospital, you'll open doors for yourself that simply do not exist in any other organization, anywhere.
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You will be asked to perform this role in an office setting or other company location.
Anticipated Work Schedule: Monday - Friday 8:30 am - 5:00 pm, plus participate in the on-call rotation where needed, with occasional additional hours as needed.
Primary Responsibilities:
- Oversee the activities of sterile compounding technicians, warehouse technicians, pharmacy clerks, and customer service advocates
- Work in the fulfillment area to provide the final quality check prior to medication being packed and shipped
- Perform all duties and functions in compliance with state and Federal pharmacy laws and regulations
- Support department quality assurance and improvement guidelines
- Verify prescriptions and prescription data entered into the pharmacy computer system for accuracy
- Conforms with and supports department quality assurance and improvement guidelines
- Review orders, prescriptions, or clinical information to make potential patient interventions, to determine urgency and accuracy or prescription interpretations and approvals
- Consult with members or others on medication use and appropriate interventions
- Review claims processing status and reasons for rejections
- Interpret and apply clinical guidelines or data to make judgments (e.g., approve prior authorizations, approve prescriptions, identify clinical interventions)
- Make clinical decisions or recommendations (e.g., approvals/denials/incomplete for lack of information decisions)
- Apply specific benefit plan criteria and guidelines to individual decisions or recommendations
- Identify relevant information, prioritize information, and collect additional clinical or benefit data as needed
- Interpret medical terminology (e.g., abbreviations) to enter information or respond to questions
- Assist intake by asking standard questions and documenting responses
- Educate others (e.g., member, guardian) regarding medical conditions, treatment, and related pharmaceutical care to motivate compliance and proper use
- Clarify and explain pharmaceutical benefits and procedures (e.g., prior authorization requirements, appeals, etc.)
- Stay current with updated drug information (e.g., recalls, monograph/insert revisions, supply issues) or other relevant departmental training (e.g., procedural changes)
- Troubleshoot and respond quickly to pharmaceutical questions and problems to provide guidance and/or manage escalations -Demonstrate empathy and concern in member interactions
- Success in this role will depend heavily upon your customer service skills and ability to thrive in a fast-paced environment
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:
- BS in Pharmacy and/or PharmD
- Pharmacist license in good standing in the State of California
- Ability to navigate MS Office and a Windows based environment and the ability to create, edit, save, and send documents utilizing Microsoft Word
- Ability to navigate Outlook and conduct Internet searches
- Ability to work the designated shift and flexible hours
- Ability to lift up to 25 pounds of IV medication
Preferred Qualifications:
- PharmD
- PGY1 Residency
- 3+ years of experience as a Pharmacist in a clinical setting
- Hospital experience
- PBM or Managed Care experience
- Mail Order Pharmacy experience
- Leadership experience
California Residents Only:The hourly range for this role is $42.31 to $83.27 per hour. 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.
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.