Pharmacy Coordinator
About The Position
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility. This is a remote position. Hours are 8:00 am- 5:00 pm PST. This position supports Coordinated Care Health Plan and requires current state's Pharmacy Technician license. Experience with HEDIS Pharmacy measures and medication adherence strongly preferred. Position Purpose: Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan's pharmacy program.
Requirements
- High school diploma or equivalent.
- 3+ years of pharmacy experience, preferably in a managed care environment.
- Medicare and/or Medicaid experience preferred.
- This is a remote position.
- Hours are 8:00 am- 5:00 pm PST.
- This position supports Coordinated Care Health Plan and requires current state's Pharmacy Technician license.
Nice To Haves
- Experience with HEDIS Pharmacy measures and medication adherence strongly preferred.
Responsibilities
- Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process
- Perform review of pharmacy and override process in compliance with pharmaceutical related company and State guidelines
- Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns
- Resolve complaints and grievances related to the pharmacy network in conjunction with the Pharmacy team
- Assist Provider Relations and various departments with educating providers on the health plan's pharmacy process
- Assist with the pharmacy utilization review and reporting process
- Collaborate with Quality Improvement department with various meeting preparation and transcription of minutes
- Assist with members' inquiries related to the formulary process
- Performs other duties as assigned
- Complies with all policies and standards
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- a flexible approach to work with remote, hybrid, field or office work schedules
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
5,001-10,000 employees
