Medical Director-Clinical Advocacy and Support - Remote

46202 Indianapolis, Indiana UnitedHealth Group

Posted 6 days ago

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Job Description

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start **Caring. Connecting. Growing together.**
Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.
The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.
The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits for all lines of business. The collaboration often involves the member's primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members.
You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
**Primary Responsibilities:**
+ Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
+ Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
+ Engage with requesting providers as needed in peer-to-peer discussions
+ Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
+ Participate in daily clinical rounds as requested
+ Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
+ Communicate and collaborate with other internal partners
+ Call coverage rotation
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:**
+ M.D or D.O.
+ Active unrestricted license to practice medicine
+ Board certification in an ABMS specialty
+ 5+ years of clinical practice experience after completing residency training
+ Sound understanding of Evidence Based Medicine (EBM)
+ Proven solid PC skills, specifically using MS Word, Outlook, and Excel
+ Ability to participate in call coverage rotation
**Preferred Qualifications:**
+ Licensed in AZ, CA, MA, MN or TX
+ Board certified in family medicine or internal medicine
+ Experience in utilization and clinical coverage review
+ Proven excellent oral, written, and interpersonal communication skills, facilitation skills
+ Proven data analysis and interpretation aptitude
+ Proven innovative problem-solving skills
+ Proven excellent presentation skills for both clinical and non-clinical audiences
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives.
_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._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment._
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Medical Director-Clinical Advocacy and Support - Remote (Indianapolis)

46220 Indianapolis, Indiana UnitedHealth Group

Posted today

Job Viewed

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Job Description

full time

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 inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

Clinical Advocacy & Support has an unrelenting focus on the customer journey and ensuring we exceed expectations as we deliver clinical coverage and medical claims reviews. Our role is to empower providers and members with the tools and information needed to improve health outcomes, reduce variation in care, deliver seamless experience, and manage health care costs.

The Medical Director provides physician support to Enterprise Clinical Services operations, the organization responsible for the initial clinical review of service requests for Enterprise Clinical Services. The Medical Director collaborates with Enterprise Clinical Services leadership and staff to establish, implement, support, and maintain clinical and operational processes related to benefit coverage determinations, quality improvement and cost effectiveness of service for members. The Medical Director's activities primarily focus on the application of clinical knowledge in various utilization management activities with a focus on pre-service benefit and coverage determination or medical necessity (according to the benefit package), and on communication regarding this process with both network and non-network physicians, as well as other Enterprise Clinical Services.

The Medical Director collaborates with a multidisciplinary team and is actively involved in the management of medical benefits for all lines of business. The collaboration often involves the members primary care provider or specialist physician. It is the primary responsibility of the medical director to ensure that the appropriate and most cost-effective quality medical care is provided to members.

Youll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

  • Conduct coverage reviews based on individual member plan benefits and national and proprietary coverage review policies, render coverage determinations
  • Document clinical review findings, actions, and outcomes in accordance with policies, and regulatory and accreditation requirements
  • Engage with requesting providers as needed in peer-to-peer discussions
  • Be knowledgeable in interpreting existing benefit language and policies in the process of clinical coverage reviews
  • Participate in daily clinical rounds as requested
  • Communicate and collaborate with network and non-network providers in pursuit of accurate and timely benefit determinations for plan participants while educating providers on benefit plans and medical policy
  • Communicate and collaborate with other internal partners
  • Call coverage rotation

Youll 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:

  • M.D or D.O.
  • Active unrestricted license to practice medicine
  • Board certification in an ABMS specialty
  • 5+ years of clinical practice experience after completing residency training
  • Sound understanding of Evidence Based Medicine (EBM)
  • Proven solid PC skills, specifically using MS Word, Outlook, and Excel
  • Ability to participate in call coverage rotation

Preferred Qualifications:

  • Licensed in AZ, CA, MA, MN or TX
  • Board certified in family medicine or internal medicine
  • Experience in utilization and clinical coverage review
  • Proven excellent oral, written, and interpersonal communication skills, facilitation skills
  • Proven data analysis and interpretation aptitude
  • Proven innovative problem-solving skills
  • Proven excellent presentation skills for both clinical and non-clinical audiences

*All employees working remotely will be required to adhere to UnitedHealth Groups Telecommuter Policy

Compensation for this specialty generally ranges from $238,000 to $357,500. Total cash compensation includes base pay and bonus and is based on several factors including but not limited to local labor markets, education, work experience and may increase over time based on productivity and performance in the role. We comply with all minimum wage laws as applicable. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, youll find a far-reaching choice of benefits and incentives.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves 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.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

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Clinical Pharmacy Technician I

46082 Carmel, Indiana Option Care Health

Posted 1 day ago

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Job Description

**Extraordinary Careers. Endless Possibilities.**
**With the nation's largest home infusion provider, there is no limit to the growth of your career.**
Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 8,000 team members including 5,000 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and employees.
As a two-year recipient of the Gallup Exceptional Workplace Award, we recognize that part of being extraordinary is building a **thriving workforce that is as unique as the patients and communities we serve.** Join a company that is taking action to develop a culture that is inclusive, respectful, engaging and rewarding for all team members. Our organization requires extraordinary people to provide extraordinary care, so we are investing in a culture that attracts, hires and retains the best and brightest talent in healthcare.
**Job Description Summary:**
Under the supervision of a licensed Pharmacist, assists with ensuring smooth and accurate pharmacy operations in accordance with Option Care Health policies & procedures, and the state's professional standards & regulations.
**Job Description:** ?
**Job Responsibilities (listed in order of importance and/or time spent)**
Prescription & Equipment Preparation and Processing
- Review/validate basic prescription drug refill requests and process according to OCH policies and procedures.
- Assists with preparing and dispensing medications & supplies.
- Assist with maintaining equipment through calibration, inspection, cleaning, testing, and informing supervisor of any defects.
Patient Support & Experience
- Collect & maintain basic patient information required to ensure accurate planning of needed materials/supplies, equipment, and prescriptions.
- Help ensure a positive patient experience through answering basic patient questions and responding to basic patient requests.
Inventory Maintenance
- Receives & verifies quantities of incoming supplies & materials.
- Stocks & stores new supplies & materials.
- Review expiration dates
- Identifying shortages
- Pick and pack materials & supplies.
- Create tickets
- Tracking of inventory through accurate data entry into applicable system(s)
- Schedule routine patient deliveries
Site & Supplies Maintenance
- Clean & sanitize surfaces and laminar hood flows.
- Clean & organize supplies.
**Supervisory Responsibilities**
Does this position have supervisory responsibilities?
(i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.)
No - X
Yes
**Basic Education and/or Experience**
**High School Diploma or GED.**
**0 to 6 months of relevant experience.**
**Licensed or registered within 6 months of hire (if required by state)**
**Successful enrollment and completion of the OCH designated training course within 6 months of hire (if licensure and/or training course is required by the state).**
**Basic Qualifications & Interests (BQIs)**
+ Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction.
+ Able to perform basic & intermediate level mathematical calculations.
+ Excellent organizational skills.
+ Basic level skill in Microsoft Word (for example: opening a document, cutting, pasting, and aligning text, selecting font type and size, changing margins and column width, sorting, inserting bullets, pictures, and dates, using find and replace, undo, spell check, track changes, review pane and/or print functions).
+ Basic level skill in Microsoft Excel (for example: opening a workbook, inserting a row, selecting font style and size, formatting cells as currency, using copy, paste and save functions, aligning text, selecting cells, renaming a worksheet, inserting a column, selecting a chart style, inserting a worksheet, setting margins, selecting page orientation, using spell check and/or printing worksheets).
+ Basic skill level in Microsoft PowerPoint (for example: inserting, rearranging, hiding, and deleting slides, navigating between slides, increasing list level, adding, centering, and editing text, changing views, inserting a table or a note, moving objects, printing outline view and/or running a slide show).
**Physical Requirements**
+ Ability to stand for extended periods of time.
+ Frequent bending, stooping, reaching.
+ Ability to carry at least 30lbs
**Travel Requirements:** **(if required)**
None
**Preferred Qualifications & Interests (PQIs)**
+ Previous healthcare or pharmacy technician experience is preferred.
May perform other duties as assigned
Due to state pay transparency laws, the full range for the position is below:
Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.
Pay Range is $17.02-$28.38
**Benefits:**
-401k
-Dental Insurance
-Disability Insurance
-Health Insurance
-Life Insurance
-Paid Time off
-Vision Insurance
_Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information._
?
For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost. Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.
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Clinical Pharmacy Technician Sr

46202 Indianapolis, Indiana Prime Therapeutics

Posted 6 days ago

Job Viewed

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Job Description

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
**Job Posting Title**
Clinical Pharmacy Technician Sr
**Job Description**
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
**Responsibilities**
+ Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system.
+ Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.
+ Escalates requests to Pharmacist when request requires extensive clinical review or denial.
+ Monitors telephone system to ensure adequate staffing to maintain client services levels.
+ Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.
+ Demonstrates, advocates and reinforces a positive team environment.
+ Other duties as assigned.
**Education & Experience**
+ Education Level
+ GED
+ High School
+ Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
+ 2+ years Pharmacy
Must be eligible to work in the United States without the need for work visa or residency sponsorship.
**Additional Qualifications**
+ Must have an active pharmacy technician licensure or registration in accordance with state requirements.
+ If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
+ In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
+ Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
+ In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
+ Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
+ Excellent written and verbal communication skills.
+ Ability to follow clinical criteria and instructions to approve prior authorization requests.
+ Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
+ Ability to identify and trouble-shoot problematic issues.
**Preferred Qualifications**
**Physical Demands**
+ Must be able to remain in a stationary position 50% of the time. Must be able to "move or traverse"
+ Must be able to constantly operate a computer and/or other office productivity equipment
+ Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information
+ Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page ( and click on the "Benefits at a glance" button for more detail.
_Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law? ?_
_We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._
_Prime Therapeutics LLC is a Tobacco-Free Workplace employer._
Positions will be posted for a minimum of five consecutive workdays.
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law? ?
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1. or email
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Clinical Pharmacy Technician Sr

46202 Indianapolis, Indiana Prime Therapeutics

Posted 6 days ago

Job Viewed

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Job Description

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
**Job Posting Title**
Clinical Pharmacy Technician Sr
**Job Description**
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
**Responsibilities**
+ Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system.
+ Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.
+ Escalates requests to Pharmacist when request requires extensive clinical review or denial.
+ Monitors telephone system to ensure adequate staffing to maintain client services levels.
+ Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.
+ Demonstrates, advocates and reinforces a positive team environment.
+ Other duties as assigned.
**Education & Experience**
+ Education Level
+ GED
+ High School
+ Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
+ 2+ years Pharmacy
Must be eligible to work in the United States without the need for work visa or residency sponsorship.
**Additional Qualifications**
+ Must have an active pharmacy technician licensure or registration in accordance with state requirements.
+ If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
+ In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
+ Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
+ In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
+ Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
+ Excellent written and verbal communication skills.
+ Ability to follow clinical criteria and instructions to approve prior authorization requests.
+ Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
+ Ability to identify and trouble-shoot problematic issues.
**Preferred Qualifications**
**Physical Demands**
+ Must be able to remain in a stationary position 50% of the time. Must be able to "move or traverse"
+ Must be able to constantly operate a computer and/or other office productivity equipment
+ Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information
+ Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page ( and click on the "Benefits at a glance" button for more detail.
_Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law? ?_
_We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._
_Prime Therapeutics LLC is a Tobacco-Free Workplace employer._
Positions will be posted for a minimum of five consecutive workdays.
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law? ?
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1. or email
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Clinical Pharmacy Technician Sr

46202 Indianapolis, Indiana Prime Therapeutics

Posted 6 days ago

Job Viewed

Tap Again To Close

Job Description

Our work matters. We help people get the medicine they need to feel better and live well. We do not lose sight of that. It fuels our passion and drives every decision we make.
**Job Posting Title**
Clinical Pharmacy Technician Sr
**Job Description**
Evaluates and authorizes approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria.
**Responsibilities**
+ Determines appropriateness for medications. Communicates decision to physicians, physician`s office staff, medical management staff and/or pharmacists. Researches, resolves and documents prior authorization outcomes in pharmacy system.
+ Communicates selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician`s office staff, medical management staff and/or pharmacists.
+ Escalates requests to Pharmacist when request requires extensive clinical review or denial.
+ Monitors telephone system to ensure adequate staffing to maintain client services levels.
+ Assesses training needs within the team. Serves as a training resource, mentor and coach to others. Identifies and shares best practices.
+ Demonstrates, advocates and reinforces a positive team environment.
+ Other duties as assigned.
**Education & Experience**
+ Education Level
+ GED
+ High School
+ Required CPT/ExCPT/LPT/PTCB/RPT, Pharmacy Technician, State Requirements - Pharmacy
+ 2+ years Pharmacy
Must be eligible to work in the United States without the need for work visa or residency sponsorship.
**Additional Qualifications**
+ Must have an active pharmacy technician licensure or registration in accordance with state requirements.
+ If state does not require an exam for licensure/registration, must possess both active pharmacy technician licensure or registration in accordance with state requirements AND an active national certification (e.g., PTCB or ExCPT).
+ In states that do not require licensure or registration, must have an active national certification (e.g., PTCB or ExCPT).
+ Specialty or retail pharmacy industry experience, previous reimbursement experience, and/or working in a health plan/health care setting.
+ In-depth knowledge of specialty injectable prescription drugs, disease states, health plan formulary management techniques, medical terminology and current diagnostic and reimbursement coding (J/Q codes, ICD-9, CMS 1500, etc.).
+ Proficiency in Pharmacy computerized systems and software applications, as well as MS Office Product Suite.
+ Excellent written and verbal communication skills.
+ Ability to follow clinical criteria and instructions to approve prior authorization requests.
+ Minimum of 2 years dispensing or retail experience required, or equivalent internal training will be substituted.
+ Ability to identify and trouble-shoot problematic issues.
**Preferred Qualifications**
**Physical Demands**
+ Must be able to remain in a stationary position 50% of the time. Must be able to "move or traverse"
+ Must be able to constantly operate a computer and/or other office productivity equipment
+ Must be able to hear and constantly communicate information and ideas. Must be able to exchange accurate information
+ Occasionally required to lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their job, and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Potential pay for this position ranges from $19.23 - $28.85 based on experience and skills.
To review our Benefits, Incentives and Additional Compensation, visit our Benefits Page ( and click on the "Benefits at a glance" button for more detail.
_Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law? ?_
_We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law._
_Prime Therapeutics LLC is a Tobacco-Free Workplace employer._
Positions will be posted for a minimum of five consecutive workdays.
Prime Therapeutics' fast-paced and dynamic work environment is ideal for proactively addressing the constant changes in today's health care industry. Our employees are involved, empowered, and rewarded for their achievements. We value new ideas and work collaboratively to provide the highest quality of care and service to our members.
If you are looking to advance your career within a growing, team-oriented, award-winning company, apply to Prime Therapeutics today and start making a difference in people's lives.
Prime Therapeutics LLC?is proud to be an equal opportunity and affirmative action employer. We encourage diverse candidates to apply, and all qualified applicants will receive consideration for employment without regard to?race, color, religion, gender, sex (pregnancy, sexual orientation, and gender identity), national origin, disability, age, veteran status, or any other legally protected class under federal, state, or local law? ?
We welcome people of different backgrounds, experiences, abilities, and perspectives including qualified applicants with arrest and conviction records and any qualified applicants requiring reasonable accommodations in accordance with the law.
Prime Therapeutics LLC is a Tobacco-Free Workplace employer.
If you are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at 1. or email
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Optometric Tech - Medical Assistant

46224 Speedway, Indiana Eyeglass World

Posted 6 days ago

Job Viewed

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Job Description

Eyeglass World is part of National Vision, one of the largest optical retailers in the United States. Eyeglass World has over 100 locations across the United States and offers eye exams, contact lenses, eyeglasses, sunglasses and protective eyewear. The brand keeps customers happy with affordable prices and same-day service via in-store labs.
For more details about Eyeglass Word, visit EyeglassWorld.com ( .
At National Vision, we believe everyone deserves to see their best to live their best. We help people by making quality eye care and eyewear more affordable and accessible.
The optometric technician is key for keeping patient flow efficient, assisting the optometrist by conducting pre-screenings and testing prior to the Doctor's examination. The valuable vision tests they conduct help the optometrist provide the best care possible. This position does not require optical experience or certification, training provided!
How would you like Sundays off? Yes, every Sunday we're closed!
What would you do? - The Specifics
+ Ensures high quality patient care.
+ Maintains a professional atmosphere and appearance of doctor's office and pretest room.
+ Understands ocular terminology and diseases and knows the ocular abbreviations.
+ Explains to the patient the types of preliminary examinations.
+ Completes necessary paperwork and performs testing on patients prior to doctor examination.
+ Promotes visual field testing and retinal screenings to eligible patients.
+ Performs exam pre-screening.
+ Reviews prescriptions and/or patient information carefully and identifies special needs. Consults with the optician, Doctor or Retail Management when necessary.
+ Fills out referral forms and follow-up paperwork as required.
+ Maintains accurate and organized patient records.
+ Ensures equipment, both Doctor's and pre-test, is properly maintained.
+ Orders and maintains supplies and pharmaceuticals as directed.
+ Follows all store and corporate policies and procedures.
+ Participates in regularly scheduled mandatory communications meetings in order to keep informed of changes in corporate policies and initiatives.
Are you the right fit? - The Suitable Talent
+ Previous retail/optical experience preferred, but not required.
+ Strong customer service skills.
+ Ability to learn optical knowledge.
+ Able to give instruction in a clear and concise manner to customers.
+ Effective interpersonal skills.
+ Excellent organizational skills.
+ Detailed oriented.
+ Multitasking and time-management skills.
Taking care of our people
We understand the importance of financial health and security, and because of that, we provide competitive compensation to all Associates - including bonus potential for every position in the store! We also offer a comprehensive benefits package including health and dental insurance, 401k retirement savings with company match, flex spending account, paid personal time off, paid company holidays, parental leave, employee eyewear discount and much, much more. At National Vision, we strive to deliver opportunities for professional growth and long-term career fulfillment. We provide training programs, access to educational courses and pride ourselves on the ever-increasing amount of promotions from within.
Please see our website to learn more.
We are an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, genetic information, disability, veteran status, and other legally protected characteristics.
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