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Optum Prior Authorization Jobs in Wisconsin (NOW HIRING)

UMR

Specialty Pharmacist Full | , Wisconsin

Sheboygan, WI · On-site

$91K - $163K/yr

Specialty Pharmacist Explore opportunities with CPS, part of the Optum family of businesses. We're ... Oversee prior authorizations and utilization management, ensuring compliance with payer and program ...

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How much do optum prior authorization jobs pay per hour?

As of Sep 1, 2026, the average hourly pay for optum prior authorization in Wisconsin is $20.72, according to ZipRecruiter salary data. Most workers in this role earn between $16.49 and $20.38 per hour, depending on experience, location, and employer.

What is an Optum Prior Authorization?

An Optum Prior Authorization job involves reviewing and processing requests from healthcare providers to ensure that medical treatments, procedures, or medications meet insurance coverage guidelines. Employees in this role assess clinical documentation, verify patient eligibility, and communicate approval or denial decisions based on established criteria. The job requires attention to detail, knowledge of medical terminology, and compliance with healthcare regulations. It may also involve interacting with providers or patients to clarify authorization requirements.

What are the typical daily responsibilities of an Optum Prior Authorization specialist?

As an Optum Prior Authorization specialist, your daily tasks include reviewing and processing prior authorization requests for various medical services, verifying insurance coverage, and ensuring all required clinical documentation is complete. You will regularly communicate with healthcare providers, insurance representatives, and patients to clarify requests and resolve any questions. Attention to compliance with health plan guidelines and accurate data entry are vital. The role is fast-paced and highly collaborative, providing opportunities to develop expertise in healthcare administration while supporting the delivery of timely patient care.

What are the key skills and qualifications needed to thrive in the Optum Prior Authorization position, and why are they important?

To thrive as an Optum Prior Authorization specialist, you need knowledge of medical terminology, health insurance processes, and prior authorization procedures, often supported by a background in healthcare administration or related fields. Familiarity with claims management software, electronic health records (EHRs), and payer-specific authorization platforms is essential. Strong organizational skills, attention to detail, and effective communication abilities help you excel in interacting with providers, insurers, and patients. These skills ensure timely, accurate processing of authorizations, reducing delays in patient care and fostering positive relationships with healthcare partners.

What are the most commonly searched types of Optum Prior Authorization jobs in Wisconsin?

The most popular types of Optum Prior Authorization jobs in Wisconsin are:

What are popular job titles related to Optum Prior Authorization jobs in Wisconsin?

For Optum Prior Authorization jobs in Wisconsin, the most frequently searched job titles are:

What job categories do people searching Optum Prior Authorization jobs in Wisconsin look for?

The top searched job categories for Optum Prior Authorization jobs in Wisconsin are:

What cities in Wisconsin are hiring for Optum Prior Authorization jobs?

Cities in Wisconsin with the most Optum Prior Authorization job openings:

Optum Prior Authorization jobs near you
Infographic showing various Optum Prior Authorization job openings in Wisconsin as of August 2026, with employment types broken down into 1% As Needed, 80% Full Time, 16% Part Time, 1% Temporary, and 2% Contract. Highlights an 93% Physical, 1% Hybrid, and 6% Remote job distribution, with an average salary of $43,103 per year, or $20.7 per hour.

Specialty Pharmacy Liaison Full Time

Sheboygan, WI • On-site

UnitedHealthcare
Health Care and Social Assistance • 10K+ employees

7.8

Company rating: 7.8 out of 10

Based on 705 frontline employees who took The Breakroom Quiz

134th of 898 rated healthcare providers

People enjoy working here

Good employer

Recommended by students

Learn more about UnitedHealthcareexternal

$18 - $32/hr

Other

Retirement

This job post has expired today. Applications are no longer accepted.

Job description

Specialty Pharmacy Liaison

Explore opportunities with CPS, part of the Optum family of businesses. We're dedicated to crafting and delivering innovative hospital and pharmacy solutions for better patient outcomes across the entire continuum of care. With CPS, you'll work alongside our team of more than 2,500 pharmacy professionals, technology experts, and industry leaders to drive superior financial, clinical, and operational performance for health systems nationwide. Ready to help shape the future of pharmacy and hospital solutions? Join us and discover the meaning behind Caring. Connecting. Growing together.

As a Specialty Pharmacy Liaison with CPS Solutions, LLC, you will engage directly with patients to coordinate pharmacy services through the health system's specialty and retail pharmacy. Acting as a bridge between patients, providers, and the pharmacy, this role focuses on improving prescription capture, providing follow-up counseling, and ensuring smooth communication. Key duties include processing prior authorizations, assisting with financial aid, updating clinical data, and supporting administrative tasks. The liaison works under the direct supervision of a pharmacist.

Pharmacy Location: Located within Hospital Sisters Health System in Sheboygan, WI Schedule: Monday through Friday, either 8AM-4:30PM or 8:30AM-5:00PM

Primary Responsibilities:
  • Serve as the primary point of contact between providers, specialty pharmacies, and patients to facilitate timely therapy initiation
  • Coordinate prescription intake and referrals, ensuring accurate transmission of orders and required documentation
  • Support prior authorizations and benefits investigations, collaborating with payers, pharmacies, and provider offices
  • Educate patients on the specialty pharmacy process, including next steps, timelines, and access expectations
  • Track prescription status and therapy progress, proactively resolving access, financial, or logistical barriers
  • Collaborate with clinical and care teams to support adherence, continuity of care, and patient outcomes
  • Ensure compliance with program, regulatory, and organizational requirements, including documentation and reporting standards

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:
  • High school diploma or equivalent
  • Active Pharmacy Technician license in good standing in the state of Wisconsin
  • National Pharmacy Technician Certification (e.g., PTCB or ExCPhT) required
  • Recent work experience as a Pharmacy Technician
Preferred Qualifications:
  • Experience supporting clinical pharmacy programs and performing administrative tasks such as prior authorizations and data entry
  • Solid knowledge of medication regimens, age-specific dosing, and managed care practices
  • Proficient in pharmacy systems, care management platforms, and Microsoft Office (Outlook, Word, Excel)

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. 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). The hourly pay for this role will range from $18 - $32 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

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. UnitedHealth Group is an Equal Employment Opportunity employer 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.

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

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