Pharmacy Operations Specialist
Expired Job 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 Specialist II – Benefit Operations Team – Remote WFHPosition Purpose: This role will focus on ensuring that the administration of the pharmacy program is accurate and compliant by supporting various operational tasks. This role will serve as the subject matter expert supporting various pharmacy operations tasks including but not limited to claims, formulary, benefit, and networks.
- Develop and distribute communication materials for members and providers including letters, bulletins, brochures, member handbooks, directories, newsletters and call scripts.
- Coordinate review and approval of communication materials with internal subject matter experts, compliance and marketing departments.
- Develop, review and revise materials distributed to members while ensuring appropriateness of content and readability.
- Develop, revise, monitor and coordinate content changes for the health plans websites and company intranet.
- Maintain knowledge of federal and State regulatory requirements for communications materials.
- Coordinate with external vendors for translation of communications materials.
- Develop, coordinate approval and distribution of employee communications.
Benefit Operations Team
- Review, edit and approve CMS model documents for the largest provider of government sponsored healthcare in the US while acting as communications liaison for the Pharmacy Benefit Manager (PBM).
- Achieved zero instances of non-compliance in Part D Medicare documents.
- Managed integration of model materials from multiple company acquisitions.
- Serve as project manager and SME for various communications initiatives.
- Developed training for the review of various CMS required communications
Education/Experience: Highschool Diploma or GED. Bachelor’s degree preferred. 4+ years of pharmacy experience, including 1+ year of managed care experience. Excellent verbal/written communication skills, strong problem solving, and analytical skills required. Government sponsored program (Medicare and/or Medicaid) experience preferred. Advanced Microsoft Office experience preferred (Excel, Word, PowerPoint, Visio)
License/Certification: Current state’s Pharmacy Technician license preferred
Job Specific Details:
Background in benefit and formulary operations including understanding the Medicare Part D and Part B regulations and requirements.
Subject matter expert in support of ensuring that Centene Medicare plans are setup and functioning correctly.
Analyzing complex problems and documenting their findings and offering solutions.
Excel and other data solutions databases. Proficiency in these areas is key to the successful performance of this job.
Work cross functionally within this team and also with other teams and external partners.
PBM operations or health plan oversight of pharmacy benefit operations in a plus.
Fully remote and may be located anywhere in the United States. Must be available normal business hours in your location but available for specific meetings based on other time zones such as EST & CST
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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.
