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: Track and triage all coverage determination requests for prior authorizations and Medicare Part D recipients
Track and triage coverage determination requests submitted from providers and determine if a pharmacist review is requiredObtain verbal authorizations and request detailed clinical information from prescribersApprove coverage determination requests based on defined criteriaEnter and document coverage determination request decision into the PBM system and notify providers and/or membersRespond to client inquiries regarding authorization approvals and PBM on-line applicationsRefer coverage determination requests for specialty drugs to delegated vendor or client for processingContact providers for additional information to facilitate coverage determination reviewsNotify physicians, providers and members of coverage determination request decisions

Education/Experience: High school diploma or equivalent. 1+ years of retail, hospital or mail order pharmacy experience.

License/Certification: Current state’s Pharmacy Technician license. National Certification from Pharmacy Technician Certification Board (CPhT) preferred.

Pay Range: $15.58 - $26.73 per hour

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