Devoted Health

Senior Utilization Management Pharmacy Technician

United States

Not SpecifiedCompensation
Senior (5 to 8 years)Experience Level
Full TimeJob Type
UnknownVisa
Health Insurance, HealthcareIndustries

UM Senior Pharmacy Technician

Employment Type: Full-time

Position Overview

At Devoted Health, we are dedicated to improving the health and well-being of older Americans by providing compassionate, integrated healthcare. We are a fast-growing, all-in-one healthcare company combining insurance, clinical care, service, and technology. Join us on our mission to deliver high-quality care that everyone would want for someone they love.

About the Role

As the UM Senior Pharmacy Technician at Devoted Health, you will play a crucial role in supporting our medical management operations. You will be instrumental in building strong relationships with network healthcare providers by addressing escalated issues through proactive outreach and follow-up communication. This role operates in a dynamic, fast-paced environment with frequent changes. The ideal candidate will be outgoing, detail-oriented, possess exceptional customer service skills, and demonstrate leadership potential. Strong organizational skills and enthusiasm are essential for managing multiple tasks effectively.

Responsibilities and Impact

  • Perform daily and weekly audits of the Intake process to ensure accuracy and compliance.
  • Conduct weekly internal routine audits of utilization management (UM) processes to ensure adherence to policies, guidelines, and compliance standards.
  • Provide support to team members by answering questions and offering guidance to resolve issues.
  • Assist the Leadership team with escalating issues, including providing action steps for team members and handling escalation calls.
  • Contribute to process improvements by creating, reviewing, and updating documentation.
  • Collaborate with leaders from other teams.
  • Conduct cross-functional training for Intake and UM Pharmacy Technicians.
  • Support special projects as needed.
  • Monitor work queues daily to verify tasks are completed on time, ensuring compliance metrics are met.
  • Act as the point of contact and manage project responsibilities in the absence of the manager, ensuring continuity and progress.
  • Assist in monitoring offshore clinical partners and provide support to ensure workflow efficiency.
  • Offer assistance to the team during unexpected work overloads, including triaging and entering incoming PA requests and reviewing them according to company policies and decision trees.

Schedule and Availability

  • Central Time or Mountain Time business hours are preferred.
  • Availability to rotate weekends and holidays.
  • Availability to cover team members' PTO, including all time zones.

Required Skills and Experience

  • Nationally Certified Pharmacy Technician (CPhT).
  • Minimum of three years of professional experience in the field.
  • Experience with Medicare Part B operations (e.g., pharmacy help desk, utilization management, prior authorizations).
  • Prior experience in utilization management is preferred.

Desired Skills and Experience

  • A strong desire to work closely with aging patient populations.
  • Experience caring for Medicare patients.
  • Proficiency in technology, including Gmail/G Suite.
  • A history of being organized with high attention to detail.
  • Experience with LLMs.

Compensation

  • Salary Range: $26 - $30 per hour.
  • Our salary ranges are broad to accommodate growth within the role. Your talent partner will provide more specific compensation details and information on our total rewards package during the interview process. The actual base salary offered will depend on factors such as qualifications, relevant experience, unique skills, education level, and certifications.

Skills

Utilization Management
Pharmacy Technician
Auditing
Compliance
Process Improvement
Customer Service
Team Leadership
Documentation
Communication

Devoted Health

Medicare Advantage plans with personalized support

About Devoted Health

Devoted Health provides Medicare Advantage plans aimed at simplifying and making healthcare more affordable for seniors aged 65 and older. Their plans include services like provider and pharmacy searches, prescription drug coverage, and preventive care rewards. Members pay premiums for these plans, and the company may also receive government payments for managing Medicare benefits. What sets Devoted Health apart from competitors is their high level of customer service, featuring Devoted Health Guides who assist members in navigating their healthcare options and addressing common issues with traditional insurance. Additionally, they promote preventive care through the Devoted Dollars program, which rewards members for engaging in health activities. The goal of Devoted Health is to create a more compassionate and accessible healthcare experience for its members.

Waltham, MassachusettsHeadquarters
2017Year Founded
$2,194.5MTotal Funding
SERIES_ECompany Stage
HealthcareIndustries
1,001-5,000Employees

Benefits

Comprehensive health plan
401(k) retirement plan
Generous vacation and holiday time
Lyra mental health resources
Time off to vote

Risks

Increased competition from Medicare Advantage providers like Clover Health and Oscar Health.
Potential regulatory changes affecting Medicare Advantage plans by CMS.
Rising healthcare costs could impact the affordability of Devoted Health's plans.

Differentiation

Devoted Health offers personalized assistance through Devoted Health Guides for member support.
The company emphasizes preventive care with its Devoted Dollars rewards program.
Devoted Health integrates virtual and in-home care with top local providers.

Upsides

Devoted Health raised $287 million in Series E funding in 2024.
The company expanded Medicare Advantage plans to eight new states in 2023.
Devoted Health achieved a 5-star Medicare Advantage rating in Ohio in 2023.

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