Remote Pharmacy Program Quality Coordinator

Centene Corp.; Northern (KY); Hybrid; USD 28,000 - 45,000; Full time

Job summary

Centene Corp. is seeking a Remote Pharmacy Coordinator to support the Eastern Time business day, Monday through Friday, 8:30 AM to 5:00 PM.

The role focuses on developing and coordinating the health plan's pharmacy program through outreach, data analysis, and operational support. The ideal candidate has 3+ years of pharmacy experience, strong communication, and is detail-oriented with the ability to navigate multiple software systems.

Qualifications

• 3+ years of pharmacy experience, preferably in a managed care environment.
• Experience with prior authorization and formulary processes is a plus.

Responsibilities

• Receive and respond to provider and pharmacy calls regarding prior authorization and formulary processes.
• Review pharmacy claims to identify trends and opportunities to improve compliance and adherence.
• Audit overrides and track prior authorizations to ensure criteria are met.
• Assist with education of providers on the health plan’s pharmacy process.
• Support utilization review and reporting activities and collaborate with Quality Improvement.

Skills

Pharmacy experience

Communication skills

Organization

Software proficiency

Managed care knowledge

Education

High school diploma or equivalent

Tools

Pharmacy software systems

Job description

Centene Corp. is seeking a Remote Pharmacy Coordinator to support the Eastern Time business day, Monday through Friday, 8:30 AM to 5:00 PM.

The role focuses on developing and coordinating the health plan's pharmacy program through outreach, data analysis, and operational support. The ideal candidate has 3+ years of pharmacy experience, strong communication, and is detail-oriented with the ability to navigate multiple software systems.