Pharmacy Provider Liaison

Centene Corp.; Arizona; Hybrid; USD 37,000 - 67,000; Full time

Job summary

Centene Corp. in Arizona is seeking a Provider Liaison to coordinate between providers, the health plan, and internal departments, investigating and resolving pharmacy claims issues and supporting performance improvement within physician practices.

The role requires a Bachelor’s degree in a healthcare-related field, 3+ years in public relations and pharmacy experience, knowledge of Medicare/Medicaid, and a valid driver’s license. CPhT license preferred; travel to sites is required.

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.
• CPhT license preferred.
• Valid driver’s license required.

Responsibilities

• 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.
• Educate providers regarding policies and procedures related to pharmacy issues; web site education, and problem solving.
• Perform Provider orientations (includes writing/updating orientation material when necessary).
• Must have a good driving record and the ability to travel.
• Perform other duties as assigned.

Skills

Public relations

Pharmacy knowledge

Communication

Travel willingness

Education

Bachelor’s degree in Healthcare related field

Tools

CPhT license

Claims billing/coding knowledge

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