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Centene Corporation

Pharmacy Coordinator (Medicare/Medicaid exp)

Centene Corporation - Columbus, OH

Pharmacy Coordinator (Medicare/Medicaid exp)

in

Columbus

Ohio

Description:

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

Qualifications:

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

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.

Job:

Health Insurance Operations

Organization:

Buckeye Community Health Plan

Location:

Ohio-Columbus

Requisition ID:

1079352

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3 days 21 hours ago

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Pharmacy Coordinator (Medicare/Medicaid exp) Centene Corporation - Columbus, OH, United States

   

Location: Columbus, OH

Company Profile:
Founded as a single health plan in 1984, Centene Corporation (Centene) has established itself as a national leader in the healthcare services field. Today, through a comprehensive portfolio of innovative solutions, we remain deeply committed to delivering results for our stakeholders: state governments, members, providers, uninsured individuals and families, and other healthcare and commercial organizations