Pharmacy Resolution Specialist

Centene Corporation

Pharmacy Resolution Specialist receiving and responding to calls from members and provider offices. Resolving pharmacy-related inquiries and issues while maintaining compliance with guidelines.

Posted 5/27/2026full-timeRemote • Florida • 🇺🇸 United StatesJunior💰 $16 - $27 per hourWebsite

About the role

Key responsibilities & impact

receives and responds to calls from members, provider/physician's offices, and pharmacies
makes outbound calls and enters pharmacy overrides into systems based on approved guidelines
takes member/prescriber/pharmacist inquiry calls for benefit questions
offers options including submission of a prior authorization request
thoroughly researches issues and takes appropriate action to resolve them
logs, tracks, resolves, and responds to all assigned inquiries and complaints
maintains expert knowledge on all pharmacy benefits and formularies
answers and conducts inbound and outbound calls with members and provider offices
actively involved in the initiation and providing status for prior authorization/coverage determination
identifies root cause issues to ensure enterprise solutions
assists with special projects as assigned

Requirements

What you’ll need

High School Diploma / GED
1 year of Job Specific call center/customer service experience
Must be authorized to work in the U.S. without the need for employment-based visa sponsorship

Benefits

Comp & perks

competitive pay
health insurance
401K and stock purchase plans
tuition reimbursement
paid time off plus holidays
flexible approach to work with remote, hybrid, field or office work schedules

ATS Keywords

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Applicant Tracking System Keywords

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Soft Skills

customer servicecommunicationproblem-solvingresearchinquiry resolutiontrackingloggingcomplaint resolutionprior authorizationroot cause analysis

Certifications

High School DiplomaGED