You could be the one who changes everything for our 26 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.
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.
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.
Engages in quality improvement projects including supporting the execution of prescriber mailings and tracking and maintaining physician and member responses regarding pharmacy quality outreach campaigns.
Documents and records services/activities in appropriate databases/software to ensure compliance with CMS requirements for clinical service offerings assigned in designated area (i.e., MTM services, Quality Improvement Projects, DUR, etc.).
Serve as backup for technicians in the other clinical service departments (Drug Utilization Review, Medication Therapy Management, Quality Improvement).
Performs other duties as assigned.
This is a work from home telephonic call center position. The main function is outreach to our members to complete medication reviews.
* Shifts and training are based on your time zone:
All shifts are Monday - Friday.
Education/Experience: High School or GED required. 0-1 year of experience in pharmacy operations managed care, hospitals, and/or retail environments
Licenses and Certifications: Certified Pharmacy Technician (CPhT) Preferred
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
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.
**TITLE:** Pharmacy Technician - Clinical Services (MTM)
**LOCATION:** Various, Ohio
- Call Centers
- Clinical Works
- Content Management