You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.Position Purpose: Supports the efforts of the clinical team through collaboration with prescribers and targeted beneficiaries in order to ensure appropriate, evidence-based drug selection and resolve medication-related problems.
Provides medication therapy management (MTM) services via triage of inbound calls to the MTM hotline, monitors fax line for prescriber responses and completion of failed faxes, supports the pharmacist for completion of Comprehensive Medication Reviews (CMRs) through pre-work up and case preparation, communicates with network pharmacies, prescribers, and beneficiaries to provide MTM services.
Documents and records services/activities in appropriate databases/software to ensure compliance with CMS requirements for clinical service offerings assigned in designated area
Engages in drug utilization review (DUR) by supporting the execution of DUR initiatives via meeting preparation, letter campaigns, and telephonic outreach to members/providers. Supports basic data analytic activities and tracking of interventions, and assists with preparation and documentation of responses to regulatory audits associated with the over utilization program.
Education/Experience: High School or GED required0-1 year of experience in pharmacy operations managed care, hospitals, and/or retail environmentsLicenses and Certifications: A license in one of the following is required: Certified Pharmacy Technician (CPhT) PreferredPay Range: $15.29 - $26.20 per hourCentene 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.