1+ months

Pharmacy Care Team Associate San Antonio

San Antonio, TX 78205
  • Job Code
    840581

The Senior Care Team Associate (CTA) for Pharmacy Medical Management will effectively support the successful implementation and execution of all Medical Management pharmacy programs and processes.  The Sr. Care Team Associate will provide support to the Medical Management pharmacy staff to ensure applicable program processes and operational responsibilities are met. The CTA will prepare Part B medication prior authorization requests for clinical review and will complete prior authorization requests and issue review outcome notifications to providers and members. This position will also provide support in troubleshooting any medication related issues identified by the Medical Management pharmacy staff. This position will also assist with training and orientation of new staff and will serve as a subject matter expert for existing staff to ask questions.

 

Primary Responsibilities:

  • Receives and responds to inquiries from all communication venues: e.g. phone, queue, department e-mail box or fax. Acts as a provider help desk specialist to aid providers in submitting prior authorization requests and communicating prior authorization request status

  • Coordinates and assists initial screening of prior authorization requests via all communication venues; as well as administrative preparation for clinical staff

  • Exhibits excellent phone and communication skills while providing complete and accurate information to customers

  • Requests additional or supplemental information via correspondence in order to complete prior authorization requests

  • Completes prior authorizations related to medications in the WellMed prior authorization system according to approved policies and procedures

  • Issues oral and written prior authorization outcome notifications to providers and members that comply with standards and requirements for timeliness, content, and accuracy.  Triages and resolves claims-related issues related to specialty drugs requiring prior authorization.  Requests additional review by clinical staff as needed

  • Compiles and reports data for ongoing key performance indicators and summarizes and presents findings to departmental leadership.  Notifies manager of trends they observe

  • Adheres to assigned schedule and quality metrics

  • Provides clerical and/or administrative support to clinical staff and managers for special studies, projects and reports

  • Provides excellent customer service by serving as a resource to all internal and external customers

  • Attends required meetings and participates in special committees as needed

  • Assists with training and onboarding of Medical Management Pharmacy Care Team Associates

  • May act as a team lead for ad hoc projects and departmental initiatives as assigned

  • Performs other duties as assigned

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Categories

Posted: 2019-10-12 Expires: 2019-12-12

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

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Pharmacy Care Team Associate San Antonio

UnitedHealth Group
San Antonio, TX 78205

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