Description
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.
*Must be able to work Pacific Standard Time day shift hours.
Occasional weekends and holidays are required.
- Responsible for hiring, training, scheduling and performance reviews for assigned direct reports.
- Performs quality audits and monitors workflow to ensure that all tasks are completed within the required timeframes.
- Tracks employees daily performance and provides improvement recommendations as necessary to achieve department goals and ensure optimal performance is achieved.
- Assists in the development and implementations of department standards to ensure compliance with regulatory requirements.
- Assists in the scheduling and implementation related to required department projects and tasks.
- Assists in the preparation and facilitation of monthly staff meetings.
- Meets and exceeds department goals.
- Ensures effective handling of internal, external and elevated calls/issues.
- Responsible for ensuring issues are reported and tracked appropriately to completion.
- Leads by example in a manner that supports the company core values.
- Assist with complex and/or escalated tasks
- Serves as a subject matter expert related to formulary setup, benefit design and pharmacy claims processing adjudication requirements, functionality and analysis
- Serves as lead responsible for delegation and monitoring of assigned tasks related to internal and external activities and audits.
- Manages plan year and implementation testing and ensures required tasks are completed accurately and by required due dates.
- Develop, manage, and deliver departmental training documents and presentations/training sessions
Minimum four years related pharmacy, managed care and/or health care benefits experience required
License/Certification: Current, valid and unrestricted 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.
