Pharmacy Provider Relations Specialist

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

Benefits offered by this job

Health insurance

401K

Stock purchase plan

Tuition reimbursement

Paid time off

Flexible work schedules

Job summary

Centene Corporation in Arizona seeks a Provider Liaison to act as a bridge between providers, the health plan, and corporate. You'll investigate injectable claims issues, train practices, and coordinate with internal teams to ensure positive outcomes.

This role requires a valid driver’s license, ability to travel, and AZ CPhT is preferred. Bachelor’s degree in healthcare and 3+ years in public relations and pharmacy-related work are desired.

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.
• Performs other duties as assigned.
• Complies with all policies and standards.

Skills

Communication skills

Public relations experience

Pharmacy knowledge

Billing/coding knowledge

Education

Bachelor's degree in Healthcare related field

Job description

Centene Corporation in Arizona seeks a Provider Liaison to act as a bridge between providers, the health plan, and corporate. You'll investigate injectable claims issues, train practices, and coordinate with internal teams to ensure positive outcomes.

This role requires a valid driver’s license, ability to travel, and AZ CPhT is preferred. Bachelor’s degree in healthcare and 3+ years in public relations and pharmacy-related work are desired.