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.
 

This position is fully remote.

Position Purpose: This role will deliver rapid quality and process improvement information to the technicians on their team, prepare material for and deliver in team meetings, and ultimately serving as a subject matter expert for their team.

• Responsible for normal day to day performance in operational queues similar to peers
• Lead will have added responsibility including but not limited to, delivery of rapid quality and process improvement information to the technicians on their team, preparing material for and delivering team meetings, and ultimately serving as a subject matter expert for their team
• Provide guidance to pharmacy technicians on quality assurance monitoring and productivity standards under the supervision of a people leader
• Provide recommendations for training needs and assist in developing training manuals and job aids.
• Train pharmacy technicians on daily tasks under the supervisor of a people leader
• Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is required
• Obtain verbal authorizations and request detailed clinical information from prescribers
• Approve coverage determination requests based on defined criteria
• Enter and document coverage determination request decision into the PBM system and notify providers and/or members
• Respond to client inquiries regarding authorization approvals and PBM on-line applications
• Refer coverage determination requests for specialty drugs to delegated vendor or client for processing
• Contact providers for additional information to facilitate coverage determination reviews
• Notify physicians, providers and members of coverage determination request decisions
• Performs other duties as assigned
• Complies with all policies and standards

Education/Experience: High School diploma/GED
3+ years of pharmacy experience within managed care, retail, hospital, or mail order pharmacy environment. Exposure to specialty pharmacy prescriptions preferred. Previous experience as a lead in a functional area, managing cross functional teams on large scale projects or supervisory experience including hiring, training, assigning work and managing the performance of staff.

License/Certification: Current state’s Certified Pharmacy Technician (CPhT) license preferred

Pay Range: $22.36 - $38.07 per hour

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