Pharmacy Coordinator – Fraud, Waste & Abuse (Remote)

About the role

We are seeking a Pharmacy Coordinator focused on Fraud, Waste, and Abuse (FWA) to join Centene’s Medical Management/Health Services team. In this remote position you will support the pharmacy department by reviewing referrals, investigating potential misuse, and ensuring compliance across our health plan’s pharmacy program for millions of members.

Key responsibilities

• Review and respond to FWA referrals, inquiries, and requests from internal and external stakeholders.
• Support regulatory reporting and documentation related to FWA investigations.
• Research and resolve concerns involving inappropriate billing, waste, or potential fraud.
• Communicate with members, providers, and pharmacies to gather information for preliminary reviews.
• Generate and analyze reports to identify trends and assist with program oversight.
• Assist with pharmacy utilization review, member inquiries, and provider education.
• Contribute to process improvements and maintain accurate documentation.

Required profile

• Minimum 3 years of pharmacy technician experience, preferably in a managed‑care environment.
• Experience with Medicare and/or Medicaid programs is preferred.
• High school diploma or equivalent; additional pharmacy‑related training is a plus.
• Strong attention to detail, analytical thinking, and ability to manage multiple priorities.

Required skills

• Proficiency with Microsoft Word, Excel, PowerPoint, and Outlook.
• Effective verbal and written communication with members, providers, and internal teams.

What we offer

• Competitive benefits and flexible workplace options.
• Opportunity to impact care for 28 million members.