Pharmacy Networks Specialist I

Posted:
9/30/2024, 5:52:07 AM

Location(s):
Sacramento, California, United States ⋅ California, United States

Experience Level(s):
Mid Level

Field(s):
Medical, Clinical & Veterinary

Workplace Type:
Hybrid

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.
 

Candidate must reside in 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.

  • Gather requirements and provide direction/feedback related to all benefit/formulary setup and hierarchy based on plan specifics.
  • Provides analytic support related to pharmacy claims and trends.
  • Serve as the subject matter expert supporting various pharmacy operations tasks including but not limited to claims, formulary, benefit, and networks.
  • Serve as the subject matter expert related to specific pharmacy documents to ensure they are accurate and compliant.

Education/Experience: High School Diploma or GED

Associate’s Degree preferred: 3+ 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. Government sponsored program (Medicare and/or Medicaid) experience preferred.

Microsoft Office experience preferred (Excel, Word, PowerPoint, Visio):
License/Certification: Current state’s Pharmacy Technician license preferred

Pay Range: $54,000.00 - $97,100.00 per year

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.

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