SacramentoRecruiter Since 2001
the smart solution for Sacramento jobs

Pharmacy Coordinator-Remote

Company: Centene Corporation
Location: Sacramento
Posted on: November 23, 2022

Job Description:

You could be the one who changes everything for our 26 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.



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 reporting 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 Superior Health Plan:



Education/Experience: High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred. Previous experience in call center or fast paced pharmacy answering multi-line phone system preferred. Microsoft office experience preferred (Excel, Word, PowerPoint)



License/Certificate: Current state's Pharmacy Technician license and Pharmacy Technician Certification Board (PTCB) or the ability to obtain both license and PTCB within 30 days of the start date.



For Arizona Complete Health:



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



License/Certificate: Current Arizona Pharmacy Technician license.



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.

Keywords: Centene Corporation, Sacramento , Pharmacy Coordinator-Remote, Healthcare , Sacramento, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Sacramento RSS job feeds