Pharmacy Program Coordinator

1 week ago


Austin, Texas, United States Centene Corporation Full time

Job Summary: We are 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 pharmacy program.

Key Responsibilities:

  • Respond to provider and pharmacy calls regarding 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

Requirements:

  • High school diploma or equivalent
  • 3+ years of pharmacy experience, preferably in a managed care environment
  • Medicare and/or Medicaid experience preferred

What We Offer:

  • Competitive pay
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • A flexible approach to work with remote, hybrid, field or office work schedules

About Us:

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.



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