Pharmacy Operations Specialist I

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 I - Pharmacy Medicare Part D, Medicare Part B benefits and formulary operations with data analysis including Excel, Access, Power BI & Power Automate

Position 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 is responsible for documenting requirements, creating training materials and working directly with end users.

• Pharmacy operations experience focused on the implementation of quality process improvement efforts and with documenting requirements, creating training materials and working directly with end users.

• Provides support for escalated issues and special projects as assigned.

• Ability to conduct data analysis to support operations and exercise independent judgement.

• Conduct UAT to ensure that systems reflect accurate information.

• Performs other duties as assigned

• Complies with all policies and standards

Education/Experience: High school Diploma or GED. Associate’s degree preferred, and 3+ years of pharmacy experience, preferably in managed care environment. Government sponsored program (Medicare and/or Medicaid) experience preferred.

Advanced Excel with Access, Power BI & Power Automate, highly preferred

License/Certification: Current state’s Pharmacy Technician license preferred

Job Specific details:

• Medicare Part D and Part B medication related benefit setup, testing, oversight, and audit activities.

• Information analysis for problem solving or solution development

• Experience with and knowledge of managed car

• Understanding of Medicare Part D and Part B benefit requirements as dictated by CMS and State Regulatory agencies

• Experience with pharmacy claims processing and benefit setup

• Experience with Root Cause analysis and identifying the root causes of faults or problems

• Excel, Access, Power BI, Power Automate

*Please be sure to attach an up-to-date resume that meets all requirements above to your application.

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