You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
Pharmacy Operations Coordinator I (Pacific / PST) - Formulary and Benefit Management (FABM)
Position Purpose: This role will focus on ensuring that the administration of the pharmacy program is accurate and compliant by supporting various operational tasks.
Perform duties to support the development, coordination and maintenance of the pharmacy program.
Review benefit/formulary setup and testing (new and year over year).
Conduct claims analysis
Performs other duties as assigned
Complies with all policies and standards
Job Specific Details:
Located in or able to work Pacific Time (PST) hours.
Supports pharmacy benefit management, specific to pharmacy benefits.
Troubleshoot and resolve request related to pharmacy benefit setup.
Research and analyze reported inquiries and issues by interpreting requests, documentations, and communications from internal and external partners.
Experience in pharmacy operations and/or PBM pharmacy benefit management environment, highly preferred.
Requires managing multiple tasks through a ticketing system and additional responsibilities.
Strong ability to analyze and troubleshoot claim issues using available tools and data.
Uses excel daily to analyze and validate complex data sets.
Intermediate Excel skills (e.g., pivot tables, LOOKUP formulas, data validation, handling large datasets).
Education/Experience: High School Diploma or GED. 2+ years of pharmacy experience in managed care environment preferred
License/Certification: Current state’s Pharmacy Technician license preferred
* Please attach an up-to-date resume that meets the requirements above to your application. *
Pay Range: $19.43 - $32.98 per hourCentene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
