Pharmacy Coordinator

🔥 12 minutes ago

🇺🇸 United States – Remote

💵 $19 - $32 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💊 Pharmacist

👻 Ghost score 0%

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Centene Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1984

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Centene Corporation is a leading provider of government-sponsored healthcare services, specializing in delivering affordable and high-quality healthcare solutions. For over 40 years, Centene has focused on transforming the health of communities by expanding access to Medicaid, Medicare, and Health Insurance Marketplace services, as well as serving military communities through the TRICARE program. As the largest Medicaid managed care organization and a key participant in the Marketplace, Centene emphasizes localized healthcare delivery combined with strong partnerships with nonprofit organizations to meet the unique needs of its members. Centene is also committed to corporate sustainability and social responsibility, prioritizing environmental stewardship and ethical governance to enhance the well-being of the communities it serves.

📋 Description

• Support the pharmacy department in the development, coordination and maintenance of the health plan's pharmacy program • Conduct provider and pharmacy outreach through calls, letters, faxes, and reporting • Review pharmacy claims to identify trends and opportunities to improve compliance and medication adherence • Support quality-related initiatives • Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process • Review pharmacy and override processes in compliance with pharmaceutical-related company and State guidelines • Track and trend overrides, audit 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 pharmacy utilization review and reporting • Collaborate with Quality Improvement on meeting preparation and transcription of minutes • Assist members with inquiries related to the formulary process • Perform other duties as assigned • Comply with all policies and standards

🎯 Requirements

• High school diploma or equivalent • 3+ years of pharmacy experience • Prior PBM, health plan, and/or managed care experience highly preferred • Medicare and/or Medicaid experience preferred • Prior experience using analysis tools or systems • 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 • Ability to prioritize and successfully execute multiple tasks to completion • Current state's (Indiana) Pharmacy Technician license preferred • Ability to support Eastern Time business hours, Monday through Friday from 8:30 AM to 5:00 PM • Up-to-date resume that meets Education / Experience requirements

🏖️ Benefits

• Competitive pay • Health insurance • 401K • Stock purchase plans • Tuition reimbursement • Paid time off plus holidays • Flexible approach to work with remote, hybrid, field or office work schedules • Additional forms of incentives may be included in total compensation