We enjoy the important work we do every day on behalf of our members.
Job Summary
Under the direction of the Supervisor, Pharmacy Utilization Management, the Pharmacy Utilization Management (UM) Coordinator Senior is responsible for setting up cases in the various applications for drug prior authorization (PA) requests and performs daily quality checks to ensure compliance. The technician will run test claims once authorization are approved and reach out to members and providers as necessary.Job Description
Requirements
EDUCATION: (Minimum education & certifications required)
EXPERIENCE: (Years of experience)
SKILL REQUIREMENTS: (Include interpersonal skills)
WORKING CONDITIONS AND ADDITIONAL REQUIREMENTS (include special requirements, e.g., lifting, travel,
overtime)
CONFIDENTIAL DATA: All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Exposed to and required to deal with highly confidential and sensitive material and must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.
What we build together changes our customer's health for the better. We are looking for talented and innovative people to join our team. Come join us!
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