Remote Optum Clinical Review Jobs in Indiana (NOW HIRING)

Overview

We are looking for team members who are passionate about challenging and significant work for the good of every patient. We are searching for individuals who are compassionate, serve with a purpose, are dedicated to supporting their team, and who seek excellence every day.

Sound like a perfect match? Apply now - we can't wait to hear from you!

Why Join IU Health?

As Indiana's largest and most comprehensive healthcare system, and the number 1 ranked healthcare system in Indiana, we offer:

• 401(K) retirement savings with employer match
• Tuition reimbursement
• Student loan forgiveness - Government program that may allow qualifying participants to have the remainder of their student loan balance forgiven (after a set amount of time and specific qualifications have been met).
• Employee Assistance Program - Counseling at no cost to you
• Healthy Results - Participation in our team member wellness programs award points that contribute toward a biweekly financial incentive in your paycheck! The more you participate, the more you earn!

Prior Authorization Pharmacy Technician

Position Summary

IU Health has an exciting opportunity as we expand our Pharmacy Refill and Pharmacy Prior Authorization Departments. This position will be based in Plainfield, IN out of our Integrated Service Center but will eventually provide the opportunity for a hybrid/remote schedule.

The Prior Authorization Pharmacy Technician plays a vital role in supporting providers and patients by facilitating medication prior authorization requests with insurance payers. This position works closely with providers, clinical staff, pharmacists, and insurance companies to ensure timely and accurate completion of prior authorizations, helping patients gain access to necessary medications. Technicians in the prior authorization department work at the top of their license in Indiana, utilizing strong analytical skills, attention to detail, and medication knowledge. This is an excellent opportunity for experienced pharmacy technicians seeking to expand their skill set in a clinical, officebased environment.

Key Responsibilities

• Initiate, process, and track prior authorization requests for prescription medications
• Collaborate with providers and clinical staff to gather required clinical documentation and supporting information
• Communicate with insurance companies and pharmacy benefit managers to determine coverage requirements and authorization status
• Accurately document prior authorization activity, outcomes, and payer responses in the electronic medical record and pharmacy systems
• Review medication requests for completeness, accuracy, and appropriateness prior to pharmacist review
• Follow up on pending prior authorizations to ensure timely resolution and minimize delays in patient care
• Communicate professionally with providers, clinic staff, and pharmacies regarding authorization status and next steps
• Ensure all work complies with state regulations, payer guidelines, and organizational policies
• Support pharmacists and the broader pharmacy team as needed

Knowledge, Skills, and Abilities

• Strong attention to detail and ability to analyze insurance requirements and medication information
• Solid knowledge of common drug names, therapeutic classes, and pharmacy terminology
• Excellent written and verbal communication skills
• Ability to manage multiple requests simultaneously while meeting deadlines
• Strong organizational and problemsolving skills
• Ability to work independently while contributing to a collaborative team environment
• Commitment to accuracy, quality, and patient safety

Qualifications

• High School Diploma or GED required
• Active Indiana Pharmacy Technician License required
• Minimum of one (1) year of pharmacy technician experience (retail experience preferred; hospital or clinic experience considered)
• Prior authorization or insurancerelated experience preferred but not required
• Requires Pharmacy Technician National Certification within one year of hire unless enrolled in accredited college of pharmacy or enrolled in or graduated from an ASHP/ACPE accredited Pharmacy Technician training program.   

Work Environment & Schedule

• Officebased setting within a providersupported prior authorization team
• Set schedule with no nights, weekends, or holidays
• After an initial training period, partial remote work opportunities may be available based on performance, accuracy, and departmental metrics

Why Join This Team?

• Work at the top of your pharmacy technician license in Indiana
• Gain valuable experience in prior authorizations and insurance processes
• Enjoy a predictable schedule that supports worklife balance
• Be part of a collaborative, growing team in an officebased environment
• Opportunity for professional growth and advancement within the pharmacy field

• Indiana University Health has nearly 40,000 team members, including more than 3,600 physicians and 1,200 advanced practice providers, and we're home to the largest nursing network in Indiana with more than 9,000 nursing team members at over 800 sites of care.
• IU Health is ranked No. 1 in Indiana by U.S. News & World Report, Riley Children's Health is ranked among the top children's hospitals in the country by U.S. News & World Report.
• A unique partnership with the Indiana University School of Medicine - one of the nation's largest medical schools - gives patients access to groundbreaking research and innovative treatments, and it offers team members access to the latest science and the very best training - advancing healthcare for all.
• With 15 hospitals, including seven with Magnet designation and eight with Pathways to Excellence designation, our team members are leading the way through excellence.
• At Indiana University Health, your personal and professional growth is a top priority. You will have access to many diverse opportunities to learn and develop in meaningful ways that matter most to you, such as advanced clinical training, leadership development, promotion opportunities and cross training development.
• Indiana University Health is invested in the lives of Hoosiers, leading the transformation of healthcare to make Indiana one of the nation's healthiest states.