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Pharmacy Coordinator
Centene Corporation. Support the pharmacy department in the development, coordination and maintenance of the health plan's pharmacy program .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in pharmacy program support, including compliance with pharmaceutical guidelines and quality improvement initiatives. Proficient in provider outreach, claims analysis, and utilization review within managed care environments.
Highest-signal resume keywords
Pharmacy ExperiencePrior Authorization ProcessQuality Process ImprovementClaims AnalysisProvider Outreach
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Pharmacy Claims ReviewUtilization AnalysisQuality Improvement ImplementationDocumentation of RequirementsTraining Material Creation
Soft Skills
Strong Communication SkillsOrganizedDetail-OrientedAbility to Prioritize Tasks
Tools & Technologies
Analysis ToolsMultiple Software Systems
Certifications & Qualifications
Pharmacy Technician License
Industry Keywords
PBMHealth PlanManaged CareMedicareMedicaid
About the role
Key responsibilities & impact- Support the pharmacy department in the development, coordination and maintenance of the health plan's pharmacy program
- Conduct provider and pharmacy outreach through calls, letters, faxes, and reporting
- Review pharmacy claims to identify trends and opportunities to improve compliance and medication adherence
- Support quality-related initiatives
- Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process
- Review pharmacy and override processes in compliance with pharmaceutical-related company and State guidelines
- Track and trend overrides, audit prior authorizations, analyze cost, and determine utilization patterns
- Resolve complaints and grievances related to the pharmacy network in conjunction with the Pharmacy team
- Assist Provider Relations and various departments with educating providers on the health plan’s pharmacy process
- Assist with pharmacy utilization review and reporting
- Collaborate with Quality Improvement on meeting preparation and transcription of minutes
- Assist members with inquiries related to the formulary process
- Perform other duties as assigned
- Comply with all policies and standards
Requirements
What you’ll need- High school diploma or equivalent
- 3+ years of pharmacy experience
- Prior PBM, health plan, and/or managed care experience highly preferred
- Medicare and/or Medicaid experience preferred
- Prior experience using analysis tools or systems
- Experience in the implementation of quality process improvement efforts
- Experience documenting requirements, creating training materials and working directly with end users
- Strong communication skills
- Organized and detail-oriented
- Comfortable navigating multiple software systems
- Ability to prioritize and successfully execute multiple tasks to completion
- Current state's (Indiana) Pharmacy Technician license preferred
- Ability to support Eastern Time business hours, Monday through Friday from 8:30 AM to 5:00 PM
- Up-to-date resume that meets Education / Experience requirements
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation