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Optumrx Prior Authorization Jobs (NOW HIRING)

Insight Global

Pharmacist

Colorado Springs, CO · Remote

$59/hr

OptumRx Position: Pharmacist Locations : REMOTE across the US working EST, CST or PST Duration ... The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating ...

RXinsider LTD.

The role provides clinical support for OptumRx account management, operations, information ... Serve as the Prior Authorization Call Center Liaison * Provide education for clients, pharmacists ...

Amylyx Pharmaceuticals

UnitedHealthGroup - UHC/OptumRx/Emisar * Kaiser Permanente * Assigned national and regional payer ... prior authorization concepts, utilization management frameworks, and formulary review processes.

UMR

Part Time Pharmacist Community

Parkersburg, WV · On-site

$44.09 - $78.70/hr

At OptumRx, a part of the UnitedHealth Group family of businesses, we're reinventing Pharmacy ... Review requests for prescription prior authorizations * Oversee the activities of pharmacy ...

divvyDOSE

Part Time Pharmacist Community

Parkersburg, WV · On-site

$44.09 - $78.70/hr

At OptumRx, a part of the UnitedHealth Group family of businesses, we're reinventing Pharmacy ... Review requests for prescription prior authorizations * Oversee the activities of pharmacy ...

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How much do optumrx prior authorization jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for optumrx prior authorization in the United States is $19.27, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $20.43 per hour, depending on experience, location, and employer.

What is an OptumRx Prior Authorization?

An OptumRx Prior Authorization is a review process used by OptumRx, a pharmacy benefit manager, to determine if a prescribed medication is medically necessary and covered under a patient's pharmacy benefit plan. Before certain medications are approved and paid for by insurance, providers must submit documentation showing the need for the drug. This process helps ensure safe, effective, and cost-efficient use of prescription medications, sometimes requiring alternative therapies to be tried first. If approved, the patient can receive the medication with their insurance coverage; if denied, alternative options may be recommended.

What are some common challenges faced by OptumRx Prior Authorization specialists, and how can they be overcome?

OptumRx Prior Authorization specialists often encounter challenges such as navigating complex insurance policies, keeping up with frequent policy updates, and managing high call or case volumes. These challenges require strong attention to detail, effective communication with providers and patients, and the ability to quickly adapt to changing guidelines. To overcome these obstacles, specialists benefit from ongoing training, utilizing internal knowledge bases, and collaborating closely with pharmacists and other team members to ensure accurate and timely authorizations.

What are the key skills and qualifications needed to thrive as an OptumRx Prior Authorization specialist, and why are they important?

To thrive as an OptumRx Prior Authorization Specialist, you need a solid understanding of pharmacy benefit management, medication terminology, and insurance processes, typically supported by a pharmacy technician certification or relevant healthcare experience. Familiarity with prior authorization software, claims processing systems, and electronic health records is essential. Strong attention to detail, communication skills, and problem-solving abilities help you efficiently evaluate requests and interact with providers and patients. These skills ensure accurate, timely medication access and compliance with insurance policies, directly impacting patient care and satisfaction.

What is the difference between Optumrx Prior Authorization vs Pharmacy Technician?

AspectOptumrx Prior AuthorizationPharmacy Technician
CredentialsMay require licensing or certification depending on stateHigh school diploma or equivalent; certification optional
Work EnvironmentHealthcare administration, insurance, and pharmacy settingsRetail or hospital pharmacy settings
Employer & IndustryHealth insurance companies, pharmacy benefit managersPharmacies, hospitals, healthcare facilities
Primary ResponsibilitiesReviewing and obtaining prior authorizations for medicationsProcessing prescriptions, assisting pharmacists, customer service

Optumrx Prior Authorization specialists focus on managing insurance approvals for medications, requiring knowledge of insurance policies and healthcare regulations. Pharmacy Technicians handle medication dispensing and customer support in pharmacy settings. While both roles involve pharmacy-related tasks, they differ in responsibilities, credentials, and work environments.

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Optumrx Prior Authorization jobs near you
Infographic showing various Optumrx Prior Authorization job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 77% Full Time, 19% Part Time, 1% Temporary, and 2% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $40,074 per year, or $19.3 per hour.

Remote Prior Authorization Pharmacist

Orlando, FL • Remote

Insight Global
See more jobs at Insight Globalexternal

$59/hr

Contractor

Medical, Dental, Vision, Life

Posted 18 days ago

Job description

Company: OptumRx

Position: Pharmacist and Certified Pharmacy Technician

Openings: 895 total – 380 Remote Pharmacists and 515 Remote Certified Pharmacy Technicians

Locations: REMOTE across the US working EST, CST or PST

Duration: 6 – 10 months – extensions are based on business demand

  • All contractors are expected to work the full assignment.
  • Some assignments can convert permanent based on business demand and performance.

Start date: Rolling start dates, 8/31-11/23 – all start dates can be found on Airtable.

Schedule: Will vary depending on hiring class, information located on Air Table

  • Lunch is 30 minutes; lunch is not paid.
  • They will get 2, 15-minute breaks.
  • Candidates with no time off request will be prioritized. 100% attendance during training is required. Candidates with more than 3 days off during the contract period will not be considered.

Interview Process: Group interview lead by IG AM and OptumRx

  • 5 Pharm Tech: 1 OptumRx Hiring Manager
  • 3 RPh: 1 OptumRx Hiring Manager


PHARMACIST – RPh

Must Haves

-Bachelors or Doctorate of Pharmacy; Active State Pharmacist License

-Current Licensed Pharmacist within the state of work

-6+ months of customer service/customer relations with healthcare professionals

-Technology savvy - Basic proficiency with Microsoft Excel (ability to create, edit, and save a basic spreadsheet), Microsoft Word (ability to create, edit, and save a basic document) and basic proficiency with Microsoft Outlook (ability to send emails)

-Comfortable with production-based environment

-Ability to perform responsibilities and duties remotely with little to no supervision

-Comfortable in a fast-paced, high-volume workload

-Ability to be adaptable, team-oriented culture requiring flexibility and adaptability to changing business needs.

 

Job Description:

The Pharmacist, Prior Authorization (PA) & Appeals, is responsible for reviewing and evaluating prior authorization and appeals requests to determine coverage based on clinical guidelines, pharmacy policies, and health plan benefits. In this fast-paced, high-volume environment, the pharmacist works closely with physicians, healthcare providers, pharmacy technicians, and internal teams to gather and assess clinical information, make evidence-based coverage determinations, recommend formulary-compliant and cost-effective treatment alternatives, and ensure compliance with federal and state regulations. The role requires strong clinical judgment, attention to detail, effective communication skills, and the ability to manage competing priorities while meeting productivity and quality standards. Additionally, the pharmacist supports quality assurance initiatives, resolves provider and pharmacy inquiries, participates in process improvement efforts, and contributes to a collaborative, customer-focused team environment. Maintain full compliance with state and federal pharmacy laws, Medicare Part D, Medicaid, and commercial benefit regulations. Accurately document case decisions in accordance with internal protocols, auditing standards, and confidentiality policies.  Effectively manage case volume by organizing workload, setting daily priorities, and meeting productivity and quality benchmarks. Adapt to fluctuating demands while maintaining accuracy and professionalism under pressure.