Senior pharm pa/appeals technician - remote in maine or vermont

Realistic Job Preview Video Remote in Vermont or Maine 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 to start Caring. Connecting. Growing together. Senior Pharmacy PA/Appeals Technician include supporting the prior authorization and appeals process by providing accurate, timely, and professional service to members, providers, pharmacists, and internal business partners.

This role is responsible for receiving, researching, documenting, and processing prior authorization requests for formulary and non-formulary medications through multiple intake channels, including phone, fax, and electronic systems. The technician reviews request information against established criteria, verifies required member, provider, medication, diagnosis, benefit, and plan details, identifies missing information, and routes clinical questions or judgment-based decisions to the appropriate pharmacist or clinician. The position requires strong attention to detail, compliance with regulatory and contractual requirements, adherence to turnaround times (TATs) and service level agreements (SLAs), and clear documentation of all interactions and case actions. Work Schedule: 8-hour shift Monday - Friday between 8am - 8pm EST with rotating on-call weekend responsibilities on Saturdays or Sundays, overtime, & holidays (work schedule will vary based on business needs) Vermont or Maine, you will enjoy the flexibility to telecommute* as you take on some tough challenges. Primary Responsibilities: Additional Qualifications/Responsibilities: Patient Safety & Quality Initiatives: What are the reasons to consider working for United Health Group? Put it all together - competitive base pay, a full and comprehensive benefit program, performance rewards, and a management team who demonstrates their commitment to your success.

Some of our offerings include: Required Qualifications: Preferred Qualifications: Soft Skills: Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At United Health 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: United Health 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. United Health Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.