Medication Prior Auth. UM Analyst II job in Grants Pass
AllCare Health is seeking a Full-Time Medication Prior Auth (UM) Analyst II who thrives in a team environment and has the ability to provide exceptional service and skills.
AllCare Health is a southern Oregon-based health organization, led by local physicians since 1994. In a progressive model of care, we combine medical, dental, and behavioral health services to provide Medicare, Medicaid insurance coverage to our members. We also provide support to our providers through AllCare Independent Physician Association and AllCare e-Health Services.
The Medication Prior Auth (UM) Analyst II is responsible for processing medication prior authorization requests in a busy environment.
Minimum Job Qualifications:
• The ideal candidate will have a pharmacy technician certification or have a background as a medical assistant.
• Pharmacy technician certification is preferred.
• Must have experience with therapeutic drug classes/drug names.
• Must have experience with computer data entry, word processing, excel and typing.
• Must have excellent verbal and written communication skills.
• Ability to use judgement for decision making based on health plan criteria and ability to manage deadlines are critical requirements.
• Familiarity with medical records, medical terminology, ICD-10 codes, pharmacy drug claim processing and knowledge of OHP and Medicare Part D.
Essential Duties: Primary responsibilities include processing authorization requests which includes;
• Preparing requests for clinical review.
• Requesting medical records.
• Communicating with Providers, Pharmacies and our members.
Physical Demands: Must be able to sit for a minimum of 8 hours per day using telephone and computer.
AllCare offers a great working environment and competitive benefit package. There is opportunity for professional development. Candidates offered a position must be able to successfully pass a drug test and background check. Skills testing may be required.
For consideration, please submit your resume, cover letter and a list of your professional references online at: www.allcarehealth.com/careers
Please note-this is located at our office in Grants Pass and remote work is not available.
AllCare Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.