Pharmacy Operations Coordinator I

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.
 

Pharmacy Operations Coordinator I

Position Purpose: This role will focus on ensuring that the administration of the pharmacy program is accurate and compliant by supporting various operational tasks.

• Perform duties to support the development, coordination and maintenance of the pharmacy program.

• Review benefit/formulary setup and testing (new and year over year).

• Conduct claims analysis

• Performs other duties as assigned

• Complies with all policies and standards

• MCHIM paper claims reviewer

Education/Experience: High School Diploma or GED. 2+ years of retail pharmacy experience and/or pharmacy managed care environment preferred

License/Certification: Current state’s Pharmacy Technician license preferred

Job Specific Details:

• Managed Care, Retail or PBM Pharmacy Technician, highly preferred

• Pharmacy Technician license and certification is a plus

• Paper claims reviewer – Medicaid and Exchange.

• Review Reimbursement request for pharmacy for Medicaid and Exchange.

• Perform duties to support the development, coordination and maintenance of the pharmacy program.

• Review benefit/formulary setup and testing (new and year over year).

• Conduct claims analysis

Working shift: 

• Shift will be 8 hours between 8pm-8pm EST. Training mirrors trainer schedule, then flexible with schedule per business needs

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