Pharmacy Provider Liaison & Claims Support

Centene Corporation; United States; On-site; USD 56,000 - 101,000; Full time

Job summary

Centene Corporation seeks a liaison between providers, the health plan, and Corporate to resolve pharmacy claims issues and coordinate education for physician practices. This role involves on-site research, monthly meetings, and collaboration with Case Management.

Requires driving ability and travel; CPhT license preferred; Bachelor’s in healthcare field and 3+ years in public relations/pharmacy-related experience are desirable. Equal opportunity employer.

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

• 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.

Skills

Public relations

Provider liaison

Training and coaching

Communication

Healthcare knowledge

Education

Bachelor's degree in Healthcare related field

Job description

Centene Corporation seeks a liaison between providers, the health plan, and Corporate to resolve pharmacy claims issues and coordinate education for physician practices. This role involves on-site research, monthly meetings, and collaboration with Case Management.

Requires driving ability and travel; CPhT license preferred; Bachelor’s in healthcare field and 3+ years in public relations/pharmacy-related experience are desirable. Equal opportunity employer.