Looking for a way to influence the health and healthcare of many?
If so, we’d love to hear from you! Our mission-driven organization is focused on the“Triple Aim” - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.
UNITE HERE HEALTH serves 100,000+ workers and 220,000 covered lives in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!
Integrity – Must be trustworthy and principled when faced with complex situations
Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required
Communication – Ability to generate concise, compelling, objective and data-driven reports
Teamwork – Working well with others is required in the Fund’s collaborative environment
Diversity – Must be capable of working in a culturally diverse environment
Continuous Learning – Must be open to learning and skill development. As the Fund’s needs evolve, must be proactive about developing new areas of expertise
Lives our values – Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)
This position is responsible for the accurate and timely review, disposition, documentation, and system input of submitted prescription prior-authorization (PA) requests. The Prior Authorization Technician will receive inbound and initiate outbound calls to providers and members. Must be familiar with third party rejects and be able to assist in resolving rejected claims
Years of Experience and Knowledge
Experience working in a managed care setting preferred (Pharmacy Benefit Management-PBM)
Working knowledge and experience in prior authorization
Education, Licenses, and Certifications
Preferred: Certification as a Pharmacy Technician
High School Diploma or GED
Skills and Abilities