Senior Pharmacy Resolution Specialist

Centene Corporation

Senior Pharmacy Resolution Specialist acting as a subject matter expert on pharmacy issues. Handling escalated calls and providing resolutions for healthcare providers and members.

Posted 5/31/2026full-timeRemote • Florida, Texas • 🇺🇸 United StatesSenior💰 $19 - $33 per hourWebsite

About the role

Key responsibilities & impact

Act as a subject matter expert on complex pharmacy issues
Respond to escalated calls from members, provider/physician's offices, and pharmacies
Make outbound calls and enter pharmacy overrides into systems
Take member/prescriber/pharmacist inquiry calls for benefit questions
Offer options including submission of prior authorization requests
Research issues and take appropriate action to resolve them
Conduct inbound and outbound calls for claims resolution
Assist team members in guiding them to appropriate resolution of inquiries
Participate in training less experienced staff
Act as a liaison between internal departments for data gathering and problem solving
Present proposed solutions clearly
Assist with audit preparation and special project work as assigned
Comply with all policies and standards

Requirements

What you’ll need

High School Diploma / GED
2 years of experience
Call center / customer service experience
Experience in healthcare environment (pharmacy operations, managed care, pharmacy hospitals and or pharmacy retail settings)
Pharmacy technician certification preferred

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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Hard Skills & Tools

pharmacy operationsclaims resolutionprior authorization requestsdata gatheringproblem solving

Soft Skills

communicationteamworktrainingcustomer serviceliaison

Certifications

pharmacy technician certification