Centene Pharmacy Services Hiring for Pharmacy Coordinator at Florida Full Time

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.

Fully remote- must be open to working later hours/weekends when needed.

Position Purpose: Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan’s pharmacy program.

• Receive and respond to provider and pharmacy calls regarding the 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 ing process
• Collaborate with Quality Improvement department with various meeting preparation and transcription of minutes
• Assist with members’ inquiries related to the formulary process

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

For Envolve Pharmacy:
Education/Experience: High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred. Advanced Microsoft office experience preferred (Excel, Word, PowerPoint, Visio). Prior experience using analysis tools or systems (ex: web based, custom, proprietary, etc.). Experience in the implementation of quality process improvement efforts. Experience documenting requirements, creating training materials and working directly with end users. Excellent verbal and written communication skills. Strong analytical skills with attention to detail. Ability to exercise independent judgment. Ability to manage deliverables in a high pace environment.

License/Certificate: Current state’s Pharmacy Technician license preferred.

Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.

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.