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Pharmacy Coordinator

Tacoma, Washington Apply Now Job ID 009EI Category Health Insurance Operations Organization Coordinated Care Schedule Full-time
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.

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