• UnitedHealth Group
  • $115,560.00 -155,790.00/year*
  • Metairie, LA
  • Scientific Research
  • Full-Time
  • 1909 Pasadena Ave

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What you do matters. And who you do it for matters even more. If you're looking for more

meaningful impact, you should take a serious look at our growing organization. Since our founding in the mid - 90's, Peoples Health has brought innovation and compassion to Medicare patients throughout Louisiana. Now, part of the UnitedHealth Group family of companies, our team consists of over 900 people who are experienced in all aspects of care delivery, health maintenance and administrative support. It's our goal to help guide over 60,000 Medicare recipients across the broad spectrum of health and dental services. We're committed to the highest purpose; improving lives. And that makes us the singular place to do your life's best work.SM

The Peoples Health Pharmacy Benefits Coordinator facilitates coverage of prescription
drugs for members by interacting with providers, pharmacists, vendors,
other PHN employees, and the pharmacy benefits manager (PBM).

To create an exceptional service experience for our members, providers, pharmacists, other PHN employees and internal and external customers while assisting them with Pharmacy issues, inquiries and concerns.

Primary Responsibilities:

  • Provides real - time, on line access to members prescription records in order to obtain instantaneous information to disseminate and / or to process overrides, when appropriate.

  • Serves as liaison to providers, pharmacists, member services, and health services in ensuring proper utilization of pharmacy benefit.

  • Facilitate the timely processing, notification and documentation of Organizational Determinations to members, providers and pharmacies

  • Acts as a resource regarding information on the pharmacy benefit to include the drug tiers, the adjudication process, drug amount accumulations, and information regarding prior authorizations.

  • Responsible for requesting and processing of documents regarding prior authorization and exceptions processes and documenting such requests

  • Ensure DMR s are processed according to guidelines and timeframes

  • Professionalism with all aspects of position

  • Commitment to providing exceptional quality service to our members, providers, customers, and staff

  • Ability to work effectively and cooperatively as part of a team Strong communication and interpersonal skills'

  • Excellent documentation skills

  • The
    Pharmacy Benefits Coordinator facilitates coverage of prescription
    drugs for members by interacting with providers, pharmacists, vendors,
    other PHN employees, and the pharmacy benefits manager (PBM).

    Attention to detail and accuracy

  • Projection of a positive willing attitude

Required Qualifications:

  • High school diploma or GED (or higher)

  • Experience with data entry

Preferred Qualifications:

  • Competency with real - time online pharmacy authorization software

  • Pharmacy Tech Certificate

  • Experience with AMISYS, MACESS, PBS and DOC - FLO systems

  • Working knowledge of CMS / Accreditation requirements

Helping create positive customer experiences for providers and our members can drive your sense of impact and purpose. Join us as we improve the lives of millions. Learn more about how you can start doing your life's best work.SM

CareersatUnitedHealthcare Medicare & Retirement.

The Boomer generation is the fastest growing market segment in health care. And we are the largest business in the nation dedicated to serving their unique health and well - being needs. Up for the challenge of a lifetime? Join a team of the best and the brightest to find bold new ways to proactively improve the health and quality of life of these 9 million customers. You'll find a wealth of dynamic opportunities to grow and develop as we work together to heal and strengthen our health care system. Ready? It's time to do your life's best work.SM

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.

Key Words: PeoplesHealth; Metairie, LA; UHC; Pharmacy Tech

Associated topics: clinical, cytometry, disease, medicine, metabolism, patient, pharmacometrics, physiology, therapeutic, transfection

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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