Pharmacy Care Team Associate

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM


Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life's best work.(sm)

The Pharmacy Support Specialist Care Coordinator will effectively support the successful implementation and execution of all Medical Management Pharmacy initiatives and processes. The pharmacy support specialist Pharmacy Care Coordinator will provide support to Clinical Pharmacists and Nurses to ensure department goals are met. This position will primarily be responsible for conducting outbound calls to patients, pharmacies and provider offices to gather prescription and medical data, assist with troubleshooting member inquiries and providing excellent customer service to all internal and external customers.

Primary Responsibilities:
  • Conduct a high volume of outbound calls to patients to schedule telephonic appointments with clinical pharmacists, and providers to obtain important follow up information
  • Collect member's prescription and medical data from multiple computer programs
  • Document all patient interactions in a clear, concise and accurate manner in accordance with established procedures
  • Assist with triaging returned faxes and sending fax to provider offices
  • May answer inbound calls from members or providers and assists them with their inquiries
  • Routes calls to appropriate department, if necessary
  • Follow system scripting and validates member demographic information
  • Provide support to internal staff, subcontractors and providers with respect to Medicare drug related issues
  • Participate in and contributes to the overall MM pharmacy initiatives
  • Exhibit excellent phone and communication skills while providing complete and accurate information to members and provider offices.
  • Adhere to assigned schedule and maintain strict confidentiality at all times
  • Provide excellent customer service by serving as a resource to all internal and external customers
  • Attend required meetings and participates in committees as needed
  • Provide clerical and/or administrative support to clinical staff and managers for special studies, projects and reports

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.

Qualifications - External

Required Qualifications:
  • High School Diploma or GED
  • 3+ years' experience in a pharmacy or medical setting
  • Extensive knowledge of the Medicare Part D, particularly the pharmacy record review, claims, billing and reimbursement rules
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance.

Preferred Qualifications:
  • PBM experience
  • Previous auditing experience
  • General writing skills and ability to produce work free from typographical or spelling errors
  • Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies Previous retail pharmacy experience

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors., WellMed is a network of doctors, specialists and other medical professionals that specialize in providing care for 550,000+ older adults with over 16,000 doctors' offices in Texas and Florida through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity 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.

Job Keywords: Medicare Part B, IV Drugs, Prior Authorization, clinical review, pharmacy, specialty pharmacy, San Antonio, TX, Texas