Clinical - Pharmacy Coordinator 1 - 210120

Mindlance

Remote-CA, CA(remote)

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JOB DETAILS

SALARY

$20.66–$22 Per Hour

SKILLS

Administrative Skills, Analysis Skills, Biotech and Pharmaceutical, Business Growth, Call Centers, Certified Pharmacy Technician (CPhT), Clinical Support, Communication Skills, Cost Analysis, Detail Oriented, Diversity, Documentation, English Language, Fax Machines, Formulary, Gap Closure, Health Plan, Healthcare Effectiveness Data and Information Set (HEDIS), Healthcare Providers, High School Diploma, Managed Care, Medicaid, Medicare, Medications, Microsoft Excel, Microsoft Windows Operating System, Organizational Skills, Performance Analysis, Performance Management, Performance Metrics, Pharmacy, Presentation/Verbal Skills, Process Improvement, Provider Relations, Quality Management, Resolve Customer Issues, Spreadsheets, Support Documentation, Telephone Skills, Time Management, Utilization Management

LOCATION

Remote-CA, CA

POSTED

2 days ago

Job Profile Summary

Position Purpose:
Perform duties to support the efforts pharmacy department in the development, coordination and maintenance of the health plan's pharmacy program.

Education/Experience:
High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred.

For Superior Health Plan:
High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred. Previous experience in call center or fast paced pharmacy answering multi-line phone system preferred.
License/Certificate: Current state s Pharmacy Technician license and Pharmacy Technician Certification Board (PTCB) or the ability to obtain both license and PTCB within 30 days of the start date.

For Arizona Complete Health:
High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred.
License/Certificate: Current Arizona Pharmacy Technician license.

For Centene Pharmacy Services:
High school diploma or equivalent. 3+ years of pharmacy experience, preferably in a managed care environment. Medicare and/or Medicaid experience preferred. Prior experience using analysis tools or systems (ex: web based, custom, proprietary, etc.). Experience in the implementation of quality process improvement efforts. Experience documenting requirements, creating training materials and working directly with end users.
License/Certificate: Current state's Pharmacy Technician license preferred.

Responsibilities
Receive and respond to provider and pharmacy calls regarding the prior authorization and formulary process

Perform review of pharmacy and override process in compliance with pharmaceutical related company and State guidelines

Track and trend overrides to ensure criteria have been met, audit for prior authorizations, analyze cost and determine utilization patterns

Resolve complaints and grievances related to the pharmacy network in conjunction with the Pharmacy team

Assist Provider Relations and various departments with educating providers on the health plan s pharmacy process

Assist with the pharmacy utilization review and reporting process

Collaborate with Quality Improvement department with various meeting preparation and transcription of minutes

Assist with members inquiries related to the formulary process
Performs other duties as assigned

Complies with all policies and standards

EEO:

Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.

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Story Behind the Need
What is the purpose of this team? What is driving this need? (ex. Backfill for FTE or CW, new project, business growth) Describe the surrounding team (team culture, work environment, etc.) & key projects. Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?		Team Purpose This team supports pharmacist-led clinical outreach by managing the administrative workflows that enable timely member engagement, provider coordination, and care gap closure. The role plays a critical part in ensuring members receive appropriate follow-up care and access to medications, while supporting overall quality performance (HEDIS). Business Need New program expansion to support HEDIS performance improvement by providing administrative support for pharmacist interventions. As outreach volume increases, dedicated coordination support is required to maintain efficient workflows, ensure timely follow-up, and improve care gap closure outcomes. Team Environment & Key Work Remote, fast-paced, and collaboration-driven team supporting clinical outreach initiatives Highly structured, process-oriented environment with clear productivity and quality expectations
Typical Day in the Role
Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique?			Key responsibilities include: Executing administrative tasks such as faxing providers/pharmacies and tracking follow-ups Coordinating with providers, pharmacies, and members to support medication access and care gap closure Managing reporting spreadsheets and maintaining accurate documentation to support quality reporting and performance Member and provider outreach outbound Centene Applications Trucare, Omni, Pharmacy claims system, Other Applications Outlook, teams, excel,
Candidate Requirements
Education/Certification	Required: high school diploma with Pharmacy Technician training in CA				Preferred: CPhT
Licensure	Required: CA Pharmacy Technician license				Preferred:
Years of experience required: 3+ years of pharmacy experience, must be personable on the phone and ability to connect with members and providers, MUST HAVE EXCEL EXPERIENCE Nice to have: Medication therapy management experience & managed care experience Disqualifiers: No Microsoft Excel experience, Must have great verbal English communication skills (language barriers), underqualified Additional qualities to look for: Experience managing multi-step administrative workflows with strong attention to detail; Experience working in a remote environment and managing tasks independently
Top 3 must-have hard skills stack-ranked by importance			1	Ability to communicate clearly and professionally with members, providers, and pharmacies
			2	MUST have Excel experience
			3	Strong technical ability to operate and transition between multiple Windows-based systems and tools
Candidate Review & Selection
Shortlisting process Candidate review & selection Interview information Onboard process and expectations			Projected Manager Candidate Review Date:			1-2 days post shortlisting
			Type of Interviews:			Teams CAMERA ON
			Required Testing or Assessment (by Vendor):
Next Steps
Do you have any upcoming PTO?			June 19^th & 22nd 2026 July 3rd

About the Company

Mindlance

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