Pharmacy Coordinator (FWA)

Centene
Florida
Workplace: RemoteFull timeUSD 19.43 - 32.98 hourlyFunction: Executive & General ManagementExperience: 3+ yearsEducation: high_schoolSkills: ["Attention to detail","Analytical thinking","Organizational skills","Collaboration","Communication"]

Review and respond to fraud, waste, and abuse (FWA) referrals, inquiries, and requests, supporting regulatory documentation and preliminary investigations. Coordinate with members, providers, and pharmacies to gather information, resolve billing-related concerns, and generate reports to identify trends and support program oversight. Maintain accurate documentation, improve processes, and assist with pharmacy benefits calls, grievances, and member inquiries.

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FursaFursa
Centene
Centene
4 days ago

Pharmacy Coordinator (FWA)

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Source: Company careers pageValidated by: Fursa AI
Last checked: 3 hours agoStatus: Live

Job Summary

Review and respond to fraud, waste, and abuse (FWA) referrals, inquiries, and requests, supporting regulatory documentation and preliminary investigations. Coordinate with members, providers, and pharmacies to gather information, resolve billing-related concerns, and generate reports to identify trends and support program oversight. Maintain accurate documentation, improve processes, and assist with pharmacy benefits calls, grievances, and member inquiries.
Location: Florida
Workplace: Remote
Employment Type: Full time
Job Function: Executive & General Management
Seniority: Mid level

Key Responsibilities

  • •Review and respond to FWA referrals, inquiries, and requests from internal and external stakeholders.
  • •Support regulatory requests, reporting, and documentation for FWA investigations and reviews.
  • •Research and help resolve concerns involving inappropriate billing, waste, and potential FWA activity.
  • •Communicate with members, providers, and pharmacies to gather information for preliminary reviews.
  • •Generate and analyze reports to identify trends, support investigations, and assist with program oversight.

Pay and Benefits

Salary: USD 19.43 - 32.98 hourly
Perks:Health Insurance401kPaid LeavePaid HolidaysRemote Work

Key Requirements

  • •3+ years of pharmacy technician experience, preferably in a managed care environment; Medicare and/or Medicaid experience preferred.
  • •Experience in a dispensing pharmacy environment (retail, specialty, long-term care, or mail-order).
  • •Strong attention to detail, analytical thinking, and organizational skills to support FWA investigations and documentation.
  • •Ability to collaborate and manage multiple priorities in a team-oriented environment.
  • •Proficiency with Microsoft Office (Word, Excel, PowerPoint, Outlook) and excellent verbal and written communication.
Experience:3+ yearsManaged careMedicareMedicaidPharmacy technicianDispensing pharmacy
Education:High School
Skills:Attention to detailAnalytical thinkingOrganizational skillsCollaborationCommunication
Licenses:Pharmacy Technician license (current state license preferred)
Tech Stack:Microsoft OfficeWordExcelPowerPointOutlook

Company Brief

Centene
Centene Corporation is a diversified, multinational healthcare enterprise that provides government-sponsored and commercial healthcare programs and services, specializing in Medicaid, Medicare, and specialty benefits management across the United States.
Industry: Health Insurance (Payers)
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: St. Louis, United States
Founded: 1984
WebsiteLinkedIn