Clinical Implementation Specialist - Pharm
Centene Corporation
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.
**Position Purpose:** Facilitate program development and implementation for the Clinical team from requirements gathering to project planning to execution.
This is a remote role, can sit anywhere in the US, prefer EST and CST time zones.
+ Identify NCQA, PQA and state requirements and ensure development of compliant program descriptions, policies and materials
+ Develop and manage project plan for the implementation and ensure compliance with established timelines
+ Serves as a liaison to ensure key information for successful program development and implementation is gathered
+ Assist with the development policies and procedures for programs which improve gap closure and medication adherence across multiple lines of business (Medicare, Health Exchange, and Medicaid)
+ Assist in the pre-implementation development of the program launches including requirement gathering
+ Collaborate with the clinical team and various functions on rational for new clinical programs within the market on return on investment and contract deliverables
+ Research and review request for proposal (RFP) and contracts to ensure policies and procedures align with contract requirements for the state and health plan
+ Coordinate with various functions on responses for RFP submission, including gathering of success stories and data to support clinical interventions
**Education/Experience:** Bachelor’s degree in a related field or equivalent experience. Master’s degree preferred.
3+ years of implementation experience.
Experience with developing or piloting new programs.
Knowledge of NCQA and PQA is highly preferred
Pay Range: $54,000.00 - $97,100.00 per year
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
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