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Remote Optum Prior Authorization Jobs in Michigan

Legion Health

$50K - $150K/yr

... verification, billing, prior authorizations, pharmacy coordination, etc. * Commitment to ... Fully remote within the United States. * Schedule: Part-time * Compensation: $50K-150K per year ...

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Remote Optum Prior Authorization information

What is a Remote Optum Prior Authorization?

A Remote Optum Prior Authorization job involves reviewing and processing requests from healthcare providers to determine whether certain medical procedures, medications, or services will be covered under a patient's insurance plan. Employees in this role work from home and use clinical guidelines to assess the necessity and appropriateness of requested treatments. They collaborate with providers, patients, and insurance teams to ensure timely authorization decisions. This position typically requires strong communication skills, attention to detail, and familiarity with healthcare regulations and insurance policies.

How does a Remote Optum Prior Authorization specialist typically interact with healthcare providers and insurance teams?

As a Remote Optum Prior Authorization specialist, you will regularly communicate with healthcare providers, pharmacies, and insurance representatives to obtain and verify necessary information for authorizing medical procedures or medications. Most interactions occur via phone, secure messaging, or electronic health record systems, requiring clear communication and attention to detail. Collaboration is essential, as you'll often need to clarify clinical documentation with providers and ensure compliance with insurance guidelines. This role is well-suited for those who are organized, proactive, and comfortable working independently within a supportive virtual team environment.

What are the key skills and qualifications needed to thrive as a Remote Optum Prior Authorization specialist, and why are they important?

To thrive as a Remote Optum Prior Authorization Specialist, you need strong knowledge of medical terminology, insurance processes, and prior authorization protocols, typically supported by a healthcare-related degree or relevant experience. Familiarity with electronic health record (EHR) systems, insurance verification tools, and prior authorization software is essential. Excellent attention to detail, organizational skills, and effective communication are vital soft skills for efficiently managing high volumes of authorization requests and collaborating with providers. These skills ensure accurate, timely approvals and help optimize patient care while reducing administrative delays.

What is the difference between Remote Optum Prior Authorization vs Remote Optum Claims Reviewer?

AspectRemote Optum Prior AuthorizationRemote Optum Claims Reviewer
CredentialsTypically requires healthcare-related certifications, such as RN, LPN, or medical coding credentialsOften requires similar healthcare certifications, with focus on claims processing
Work EnvironmentRemote, healthcare insurance setting, interacting with providers and patientsRemote, insurance claims processing environment, reviewing submitted claims
Employer & Industry UsageCommonly employed by health insurance companies like Optum, focusing on authorization processesEmployed by insurance companies, focusing on claims review and reimbursement

Remote Optum Prior Authorization specialists focus on obtaining approvals for healthcare services, while Remote Optum Claims Reviewers evaluate submitted claims for accuracy and reimbursement. Both roles require healthcare knowledge and certifications, but differ in their primary functions within the insurance process.

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

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

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

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

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

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

What cities in Michigan are hiring for Remote Optum Prior Authorization jobs?

Cities in Michigan with the most Remote Optum Prior Authorization job openings:

Remote Optum Prior Authorization jobs near you
Infographic showing various Remote Optum Prior Authorization job openings in Michigan as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% Remote job distribution.

Patient Support Supervisor - Certified Pharmacy Technician, Prior Authorizations

Detroit, MI • Remote

Shields Health Solutions

8.4

Company rating: 8.4 out of 10

Based on 41 frontline employees who took The Breakroom Quiz

10th of 113 rated pharmacies

Great coworkers

People enjoy working here

Good employer

Learn more about Shields Health Solutionsexternal

$17.75 - $21.75/hr

Full-time

PTO

Re-posted 7 days ago

Job description

???? Patient Support Supervisor (Specialty Pharmacy)

???? Location: Remote – supporting Northeast (EST Zone)

???? About the Role

Shields Health Solutions is seeking a Patient Support Supervisor to lead a high-performing team within our Patient Support Center. This is an ideal opportunity for a motivated, service-oriented leader with a background in pharmacy or healthcare operations who thrives in a fast-paced, growth-focused environment.

The ideal candidate is a results-driven self-starter who is passionate about patient care, team development, and operational excellence, with proven experience managing front-line employees and driving performance.

 

???? Position Summary

The Patient Support Supervisor is a key leadership role responsible for overseeing daily operations of a Patient Support team and ensuring patients receive medications efficiently, accurately, and on time.

This role partners closely with internal teams and hospital stakeholders to:

  • Meet service level agreements (SLAs)
  • Ensure adoption of best practices
  • Drive team performance, engagement, and development

 

???? Key Responsibilities

???? Team Leadership & Operations

  • Lead, coach, and manage a team of Patient Support Associates to ensure medication adherence, prior authorization completion, and financial assistance support
  • Provide ongoing performance management, training, and mentorship
  • Manage staffing, scheduling, PTO, and time reporting (ADP)
  • Step in to support workload during peak or short-staffed periods

???? Patient & Partner Coordination

  • Ensure patients receive medications on time and without barriers
  • Partner with hospital/clinic stakeholders through regular meetings and collaboration calls
  • Maintain strong working relationships with pharmacy and clinical teams

???? Workflow & Performance Management

  • Monitor and ensure achievement of service level metrics and quality standards
  • Conduct audits, oversee system workflows, and manage responsiveness to incoming requests
  • Establish and optimize workflows between Patient Support, liaison teams, and clinical integration teams

???? Process Improvement & Support

  • Identify and implement operational improvements and best practices
  • Support data, analytics, contracting, and special projects
  • Provide troubleshooting, guidance, and issue resolution for team members and partners

⚙️ Administrative & Coordination

  • Assist with hiring, onboarding, training coordination, and system access setup
  • Maintain confidentiality of sensitive patient and business data

 

✅ Qualifications

???? Licensure & Experience

  • Active Pharmacy Technician license/registration (state-specific)
  • National certification (CPhT) required
  • 3+ years pharmacy technician experience (specialty pharmacy preferred)
  • Prior leadership experience (formal or informal) strongly preferred

???? Education

  • High School Diploma or GED (required)
  • Bachelor's degree (preferred or in progress)
  • Leadership/management training (preferred)

???? Skills & Competencies

  • Strong leadership, communication, and team development skills
  • Ability to influence, collaborate, and drive results across teams
  • Solid operational and analytical skills; ability to identify trends and improve performance
  • Proficiency in Microsoft Excel and Word (data analysis, reporting)
  • Experience with pharmacy/EMR systems (Willow, QS1, RX30 preferred)
  • Highly organized, detail-oriented, and patient-focused
  • Ability to manage multiple priorities and maintain confidentiality

???? Additional Requirements

  • Ability to lead both remote and on-site teams
  • Willingness to travel up to 20% (if outside core locations)

 

???? Why Join Shields?
  • ???? Fast-growing leader in specialty pharmacy
  • ❤️ Mission-driven, patient-first culture
  • ???? Strong career growth and leadership development opportunities
  • ???? Collaborative and supportive environment

 

???? SEO Keywords

Patient Support Supervisor, Pharmacy Supervisor, Specialty Pharmacy, Pharmacy Technician Supervisor, Healthcare Operations, Patient Access, Prior Authorization, Medication Adherence, Care Coordination, Patient Support Center, Pharmacy Team Lead

California residents employed by or applying for work at Shields have certain privacy rights. Please review our: California Workforce Privacy Notice and Privacy Policy.  

By providing your mobile number, you agree to receive text messages from Shields Health Solutions related to job opportunities, interview scheduling, and recruiting updates. Message and data rates may apply. You may opt out at any time by replying 'STOP.' Consent is not a condition of employment.

Solid computer skills are required, including proficiency in Microsoft Office tools (Outlook, Teams, Word, Excel, and PowerPoint) for communication, documentation, and data management, as well as, navigating the internet and web-based platforms. Data entry and computer skills will be evaluated through an assessment as part of the pre-employment process.

Shields Health Solutions provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

Shields Health Solutions is committed to providing an inclusive hiring experience; if you need assistance or accommodation during the application or interview process, please email talentacquisition@shieldsrx.com.

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