You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits, including a fresh perspective on workplace flexibility. Position Details *Qualified candidates must be available to work 10am – 6:30pm EST Monday-Friday* Position Purpose: The Senior Pharmacy Resolution Specialist acts as a subject matter expert, handling complex pharmacy issues and responding to escalated calls from members, provider/physician offices, and pharmacies. This role involves making outbound calls and entering pharmacy overrides into systems based on approved guidelines and approvals from clinical pharmacists. Key Responsibilities: Takes member/prescriber/pharmacist inquiry calls for benefit questions, including prior authorization requests. Offers options including submission of a prior authorization request. Researches issues thoroughly and takes appropriate actions to resolve them within turnaround time requirements and quality standards. Answers and conducts inbound and outbound calls with members and provider offices to resolve claims issues, such as additional information requests and medication determination updates. Guides team members in resolving complex inquiries and participates in training less experienced staff, including job shadowing opportunities. Acts as a liaison between internal departments for data gathering and problem solving, especially for unusual issues. Presents proposed solutions clearly and concisely. Assists with audit preparation and miscellaneous special projects as assigned. Performs other duties as assigned, ensuring compliance with policies and standards. Qualifications: High School Diploma / GED. At least 2 years of experience, preferably in a healthcare environment such as pharmacy operations, managed care, or retail pharmacy settings. Call center or customer service experience. Pharmacy technician certification is preferred. Compensation and Benefits: Pay Range: $19.04 - $32.35 per hour Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off and holidays, and flexible work arrangements (remote, hybrid, field, or office schedules). Actual pay will be adjusted based on skills, experience, education, and other factors. Total compensation may include additional incentives. Equal Opportunity Employment: Centene is an equal opportunity employer committed to diversity. All qualified applicants will receive consideration regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other protected characteristics. Qualified applicants with arrest or conviction records will be considered in accordance with applicable laws. #J-18808-Ljbffr