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Pharmacy Navigator - Remote in Worcester, MA - 2230813

Dovetail Health

Dovetail Health

Worcester, MA, USA
Posted on Thursday, June 13, 2024

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.

Provides operational support to the Prescription department location. Receives requests to process prescriptions in an accurate and timely manner to get providers approval. Performs assigned prescription functions and duties in support of the prescription department. Takes incoming calls and make outreach telephone calls to patients who have requested medication refills or renewals. Processes medication requests following standard procedure. Checks appropriate notes, pertinent lab results and order labs that are required to support requests being pended for provider approval. Checks if patients are up to date with appointments and books follow up appointments that are required to sustain compliance with treatments. Selects and pend correct medication, dosage, sig and number of refills with selecting correct pharmacy before routing to the appropriate provider for approval. Manages patient’s drug management agreements and updates accordingly. Processes prior authorizations for medications that are not covered by patients’ insurance. Performs tasks focused on fostering teamwork and dedication to patient safety and satisfaction.

If you reside in Worcester, MA, you will enjoy the flexibility to telecommute* as you take on some tough challenges.

Primary Responsibilities:

  • Performs assigned duties as directed by the prescription specialist supervisor
  • Interacts effectively and professionally with all location departments at Reliant Medical Group
  • Interacts effectively and professionally with all patients, prescribers and payors and pharmacies related to any and all prescription requests
  • Develops proficiencies in utilization of Epic
  • Works independently and handles multiple tasks
  • Greets patients over the telephone to ensure prompt service for patient needs.
  • Performs computer entry of prescription information including but not limited to patient search, prescriber search, drug selection, prescription interpretation, chart review, and provides accurate documentation in Epic
  • Accurately reviews and processes e-prescriptions, faxed prescriptions, my-chart renewals, patient calls per Prescription Department guidelines
  • Accepts customer, insurance and prescription information required to process new and refill prescriptions, including refill authorization from doctor offices where permitted by state law
  • Communicates any issues which may delay the prescription to the patient. Works directly with the prescription specialist supervisor to coordinate the resolution for the patient
  • Follows all downtime and emergency processes per departmental policies
  • Assists with projects, prescription initiatives and other tasks at the department as required
  • Assists with maintaining the prescription pool by keeping it up to date and while also managing open encounters and in-basket management
  • Follows all asset protection and personal safety guidelines as outlined in the department Policy and Procedures
  • Responsible for obtaining correct Prior Authorizations forms. Completes and processes prior authorizations for medications that are not covered by patient’s insurance
  • Great knowledge with insurance companies and pharmacies
  • Treats each patient with dignity and respect and is dedicated to maximum patient satisfaction
  • Conforms to all record keeping responsibilities of the department and organization
  • Follows all professional and departmental guidelines for PHI and HIPPA compliance
  • Reports any departmental, organizational, state or federal non-compliance issues to their immediate department supervisor immediately. Completes SSA in a timely fashion
  • Actively contributes to the evaluation and continuous improvement of customer services and as well as department policies, and procedures
  • Complies with established departmental policies, procedures, and objectives
  • Enhances professional growth and development through educational programs, seminars, etc.
  • Performs other similar and related duties as required or directed
  • Regular, reliable, and predicable attendance is required

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:

  • High School Diploma/GED (or higher)
  • Current state of Massachusetts Pharmacy Technician registration OR ability to obtain by date of hire (and to maintain throughout employment)
  • 1+ years of retail Pharmacy Technician experience
  • 1+ years of experience with pharmacy management software and operational platforms
  • Ability to work in office Monday through Friday for 6-week training period at from 8:30am-5pm at 5 Neponset Street Worcester, MA 01606 with the ability to work remotely after training
  • Ability to work alternate shifts including 7:00am-3:30pm, 8:30am-5:00pm, and 10:30am-7:00 pm

Soft Skills:

  • Excellent organizational skills
  • Excellent communication and interpersonal skills

*All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy.

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.

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