Pharmacy Operations Coordinator I

Centene Corporation
1d$19 - $33

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. Pharmacy Operations Coordinator I (Pacific / PST) - Formulary and Benefit Management (FABM) Job Specific Details: Located in or able to work Pacific Time (PST) hours. Supports pharmacy benefit management, specific to pharmacy benefits. Troubleshoot and resolve request related to pharmacy benefit setup. Research and analyze reported inquiries and issues by interpreting requests, documentations, and communications from internal and external partners. Experience in pharmacy operations and/or PBM pharmacy benefit management environment, highly preferred. Requires managing multiple tasks through a ticketing system and additional responsibilities. Strong ability to analyze and troubleshoot claim issues using available tools and data. Uses excel daily to analyze and validate complex data sets. Intermediate Excel skills (e.g., pivot tables, LOOKUP formulas, data validation, handling large datasets). Position Purpose: This role will focus on ensuring that the administration of the pharmacy program is accurate and compliant by supporting various operational tasks. Perform duties to support the development, coordination and maintenance of the pharmacy program. Review benefit/formulary setup and testing (new and year over year). Conduct claims analysis Performs other duties as assigned Complies with all policies and standards

Requirements

  • High School Diploma or GED.
  • 2+ years of Pharmacy experience in managed care environment preferred.
  • Microsoft Excel with complex data, highly preferred.
  • Current state’s Pharmacy Technician license and PTCB Certification preferred

Nice To Haves

  • Experience in pharmacy operations and/or PBM pharmacy benefit management environment, highly preferred.
  • Intermediate Excel skills (e.g., pivot tables, LOOKUP formulas, data validation, handling large datasets).

Responsibilities

  • Supports pharmacy benefit management, specific to pharmacy benefits.
  • Troubleshoot and resolve request related to pharmacy benefit setup.
  • Research and analyze reported inquiries and issues by interpreting requests, documentations, and communications from internal and external partners.
  • Requires managing multiple tasks through a ticketing system and additional responsibilities.
  • Strong ability to analyze and troubleshoot claim issues using available tools and data.
  • Uses excel daily to analyze and validate complex data sets.
  • Review benefit/formulary setup and testing (new and year over year).
  • Conduct claims analysis
  • Performs other duties as assigned
  • Complies with all policies and standards
  • Perform duties to support the development, coordination and maintenance of the pharmacy program.

Benefits

  • Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.
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