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.
- Develop clinical criteria for medications, recommend plan design changes, and clinical programs to be initiated
- Monitor prior authorization requests
- Provide clinical support to internal departments and address clinical related questions
- Ensure appropriate quality controls and initiates opportunities for performance improvement in pharmacy/practice
- Develop and implement programs designed to impact DUR for both Medicaid and Medicare
- Develop, implement, and maintain policies and procedures for the pharmacy department
- Participate in the coordination of the Medicare MTM program
- Assist case management team with members including clinical rounds presentations
Education/Experience: Bachelor’s degree or advanced degree (Pharm.D., M.S.) in pharmacy. 2+ years of mail order, retail, hospital or managed care pharmacy experience or 1+ years of pharmacy residency program experience.
Licenses/Certifications: Current state’s Pharmacist license with no restrictions. *Must be licensed in Nevada.
Location: Position is remote. Will work PST hours.
Pay Range: $107,700.00 - $199,300.00 per yearCentene 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, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
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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What We Do
Centene provides healthcare solutions to individuals across the United States with more than 23 million members nationwide.
