Remote Pharmacy Programs Coordinator

Centene Management Company LLC; United States; Remote; USD 27,000 - 45,000; Full time

Job summary

Centene Management Company LLC is seeking a Remote Pharmacy Coordinator to support Eastern Time business hours, Monday through Friday 8:30 AM to 5:00 PM. The role centers on developing, coordinating and maintaining the health plan's pharmacy program through quality-focused outreach and operational support.

Responsibilities include provider and pharmacy outreach, reviewing claims to identify trends, supporting quality initiatives, handling prior authorization and formulary inquiries, and

Qualifications

• High school diploma or equivalent; 3+ years of pharmacy experience in managed care preferred.
• Medicare/Medicaid experience preferred.
• Experience with analysis tools or systems.

Responsibilities

• Conduct provider and pharmacy outreach via calls, letters, faxes, and reporting.
• Review pharmacy claims to identify trends and improve adherence.
• Support quality-related initiatives.
• Assist with prior authorization and formulary processes.
• Track overrides and analyze cost and utilization patterns.
• Resolve complaints related to the pharmacy network.

Skills

Pharmacy experience

Quality improvement

Provider outreach

Medicare/Medicaid knowledge

Education

High school diploma

Pharmacy Technician license

Tools

Analysis tools

Job description

Centene Management Company LLC is seeking a Remote Pharmacy Coordinator to support Eastern Time business hours, Monday through Friday 8:30 AM to 5:00 PM. The role centers on developing, coordinating and maintaining the health plan's pharmacy program through quality-focused outreach and operational support.

Responsibilities include provider and pharmacy outreach, reviewing claims to identify trends, supporting quality initiatives, handling prior authorization and formulary inquiries, and