Pharmacy Coordinator

Centene Corporation•Remote-IN, IN

1d•$19 - $33•Remote

About The Position

This is a remote Pharmacy Coordinator role supporting Eastern Time business hours, Monday through Friday from 8:30 AM to 5:00 PM. The position supports the development, coordination, and maintenance of the health plan's pharmacy program through quality-focused outreach and operational support activities. Responsibilities include conducting provider and pharmacy outreach through calls, letters, faxes, and reporting; reviewing pharmacy claims to identify trends and opportunities to improve compliance and medication adherence; and supporting quality-related initiatives. The ideal candidate will have 3+ years of pharmacy experience, strong communication skills, be organized and detail-oriented, and comfortable navigating multiple software systems with the ability to prioritize and successfully execute multiple tasks to completion. Indiana is highly preferred but will consider other states in eastern and central time zones.

Requirements

High school diploma or equivalent
3+ years of pharmacy experience, preferably in a managed care environment
Prior experience using analysis tools or systems (ex: web based, custom, proprietary, etc.)
Experience in the implementation of quality process improvement efforts
Experience documenting requirements, creating training materials and working directly with end users
Strong communication skills
Organized and detail-oriented
Comfortable navigating multiple software systems with ability to prioritize and successfully execute multiple tasks to completion

Nice To Haves

Prior PBM, health plan, and/or managed care experience
Medicare and/or Medicaid experience
Current state's (Indiana) Pharmacy Technician license 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