Teams at Centene Corporation

Lead pharmacy operations across multiple markets and products, develop and implement pharmacy benefit management programs, manage vendor contracts and accreditation participation, analyze utilization and financial data, oversee pharmacy staff, and support provider education and budget planning to achieve organizational pharmacy and medical goals.

The Senior Business Systems Analyst collaborates with stakeholders to translate complex requirements into technical specifications, ensuring alignment with strategic goals. Responsibilities include gathering business requirements, creating process models, managing project lifecycles, and providing user support.

Review psychological testing and treatment documentation for medical necessity and quality; authorize and monitor outpatient behavioral health and substance abuse care; conduct peer reviews; consult with providers and Medical Director; educate network practitioners on best practices and utilization management; respond to complaints and provide clinical oversight for outpatient services.