Centene Corporation Pharmacy Coordinator in Smyrna, Georgia

HourlyPosition Purpose: Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan’s pharmacy program.

  • Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process

  • Perform review of pharmacy and override process in compliance with pharmaceutical related company and State guidelines

  • Track and trend overrides to ensure criteria have been met, audit for 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 the pharmacy utilization review and reporting process

  • Collaborate with Quality Improvement department with various meeting preparation and transcription of minutes

  • Assist with members’ inquiries related to the formulary process

TITLE: Pharmacy Coordinator

LOCATION: Smyrna, Georgia

REQNUMBER: 1080061

COMPANY: Health Insurance Operations