- Perform duties to support the development, coordination and maintenance of the pharmacy program.
- Review benefit(s) and testing (new and year over year).
- Conduct claims analysis
- Manage Pharmacy Medicare Eligibility tasks related to researching and updating Medicare members to the correct plan to include LIS, DOB, COB, Hospice and other demographic information.
- Research incorrect pharmacy data.
- Work with internal and external partners to collaborate on correcting member profiles for access to care.
- Weekly reporting that will be researched for eligibility errors as well as daily files for submission.
- Pharmacy Medicare
- Pharmacy Medicare eligibility
- Pharmacy claim(s) denials
- Pharmacy research and reporting
- Nationally Certified Pharmacy Technician, preferred. Pay Range: $ $31.73 per hour
Pharmacy Operations Coordinator I - Sacramento, United States - Centene Corporation
Description
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 (Medicare Eligibility) - Remote (PST)
Position Purpose: This role will focus on ensuring that the administration of the pharmacy program is accurate and compliant by supporting various operational tasks.
Education/Experience: High School Diploma or GED. 2+ years of pharmacy experience, preferably in managed care environment. Excellent verbal/written communication skills, strong problem solving, and analytical skills required. Ability to manage deliverables in a high pace environment.
License/Certification: Current state's Pharmacy Technician license preferred.
Working Shift: 8am - 4:30p PST / Pacific
Job specific details:
Highly desired:
Centene 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. Total compensation may also include additional forms of incentives.