Pharmacy Provider Liaison

Centene Corporation•Remote-AZ, AZ

1d•$27 - $49•Hybrid

About The Position

Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider physician injectable claims issues. Perform training, orientation and coaching for performance improvement within physician practices. Communicate effectively and partner with all internal departments to ensure members and providers have a positive, successful outcome. Key Details: Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Arizona Complete Health- AZ CPhT is required. At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day. You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Requirements

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future.
Arizona Complete Health- AZ CPhT is required.
Must have a good driving record and the ability to travel.
Bachelor’s degree in Healthcare related field preferred.
3+ years of combined public relations and pharmacy related experience.
Knowledge of health care, managed care, Medicare or Medicaid preferred.
Claims billing/coding knowledge preferred.
Valid driver’s license.

Nice To Haves

CPhT license preferred.

Responsibilities

Serve as primary contact for providers serving as a liaison between the provider and the health plan for all pharmacy concerns.
Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on-site and routing to the appropriate party for resolution.
Receive and respond to provider related issues.
Recommend changes in pricing subsystems.
Attend weekly meetings with Case Management to assist where needed with pharmacy or medication concerns.
Educate providers regarding policies and procedures related to pharmacy issues; web site education, and problem solving (liaison responsibilities).
Perform Provider orientations (includes writing/updating orientation material when necessary).
Performs other duties as assigned.
Complies with all policies and standards.