Pharmacy Coordinator

3 days ago

Tallahassee FL USA, United States Centene Corporation Full time
Pharmacy Coordinator Job Description

Centene Corporation is seeking a highly skilled Pharmacy Coordinator to join our Medical Management/Health Services team. As a Pharmacy Coordinator, you will play a critical role in supporting the development, coordination, and maintenance of our health plan's pharmacy program.

Key Responsibilities:
  • Respond to provider and pharmacy calls regarding prior authorization and formulary processes
  • Perform reviews of pharmacy and override processes 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 pharmacy utilization review and reporting processes
  • Collaborate with Quality Improvement department on meeting preparation and transcription of minutes
  • Assist with members' inquiries related to the formulary process
Requirements:
  • High school diploma or equivalent
  • 3+ years of pharmacy experience, preferably in a managed care environment
  • Medicare and/or Medicaid experience preferred
  • Prior experience using analysis tools or systems
  • Experience in implementing quality process improvement efforts
  • Experience documenting requirements, creating training materials, and working directly with end-users
Location:

Remote Florida - Candidates must be based out of Florida

License/Certificate:

Current state's Pharmacy Technician license preferred (Florida)

Schedule/Working Shift:

Open flexibility required - Full-time / 40 hours - 5 days/week. Need to be available anytime from Sunday-Saturday from 8:00AM – 7:00PM (EST). Shifts will be determined after the candidate is hired, based on business need.

Pay Range:

$31.73 per hour

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.

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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