Pharmacy Provider Liaison

Centene Management Company LLC; Arizona; Hybrid; USD 37,000 - 66,000; Full time

Benefits offered by this job

Competitive pay

Health insurance

401K plan

Stock purchase plan

Tuition reimbursement

PTO & holidays

Flexible work model

Job summary

Centene Management Company LLC is seeking a provider liaison role in Arizona to connect physicians and the health plan, resolve pharmacy issues, and drive performance improvements. The role includes training, on-site meetings, and updating orientation materials to ensure compliant and efficient provider interactions.

You will partner with internal teams, attend weekly case management discussions, and support policy education for providers with a flexible work schedule including remote/hybrid

Qualifications

• Bachelor's degree in healthcare-related field preferred.
• 3+ years of combined public relations and pharmacy-related experience.
• Knowledge of health care, managed care, Medicare or Medicaid preferred.
• Claims billing/coding knowledge preferred.

Responsibilities

• Act as liaison between providers, health plan and corporate to resolve pharmacy issues.
• Conduct monthly face-to-face meetings with providers and document discussions and action items.
• Educate providers on pharmacy policies, procedures, and problem solving.
• Provide provider orientations and update materials as needed.
• Travel as required and maintain driving record.

Skills

Public relations

Pharmacy experience

Communication

Education

Bachelor's degree in Healthcare related field

Job description

Position Purpose

Perform duties to act as a liaison between providers, the health plan and Corporate including investigating and resolving provider physician injectable claims issues. Perform training, orientation and coaching for performance improvement within physician practices. Communicate effectively and partner with all internal departments to ensure members and providers have a positive, successful outcome.

Key Details

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT. Arizona Complete Health- AZ CPhT is required. Serve as primary contact for providers serving as a liaison between the provider and the health plan for all pharmacy concerns. Conduct monthly face to face meetings with the providers documenting discussions, issues, attendees, and action items researching claims issues on-site and routing to the appropriate party for resolution. Receive and respond to provider related issues. Recommend changes in pricing subsystems. Attend weekly meetings with Case Management to assist where needed with pharmacy or medication concerns. Educate providers regarding policies and procedures related to pharmacy issues; web site education, and problem solving (liaison responsibilities). Perform Provider orientations (includes writing/updating orientation material when necessary). Must have a good driving record and the ability to travel. Performs other duties as assigned. Complies with all policies and standards.

Education/Experience

• Bachelor's degree in Healthcare related field preferred.
• 3+ years of combined public relations and pharmacy related experience.
• Knowledge of health care, managed care, Medicare or Medicaid preferred.
• Claims billing/coding knowledge preferred.

License/Certification

• Valid driver's license.
• CPhT license preferred.

Pay Range

$27.02 - $48.55 per hour

Centene Company Overview

At Centene, we connect people to the care they need to live healthier lives - and the work you do here makes that impact real every day. You'll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It's work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Should you need an accommodation, please email [e-mail]. Centene is committed to helping people live healthier lives. We provide access to high-quality healthcare, innovative programs and a wide range of health solutions that help families and individuals get well, stay well and be well.

Benefits

• competitive pay
• health insurance
• 401K and stock purchase plans
• tuition reimbursement
• paid time off plus holidays
• flexible approach to work with remote, hybrid, field or office work schedules

Compensation

Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Equal Opportunity Employer

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different.

EEO/DEI Inclusive Statement

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