Join Our Team: Do Meaningful Work and Improve People’s Lives
Our purpose, to improve customers’ lives by making healthcare work better, is far from ordinary. And so are our employees. Working at Premera means you have the opportunity to drive real change by transforming healthcare.
To better serve our customers, we’re creating a culture that promotes employee growth, collaborative innovation, and inspired leadership. We are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!
As a Pharmacy Services Specialist I you will support Pharmacy Service Operations and pharmacy programs to promote an optimum level of efficiency for both provider and customer satisfaction. Complete pharmacy prior authorization review requests from providers.
Core service hours: Monday through Friday 7:30 to 6 pm. Regular Saturday and Sunday rotation required; estimated weekend coverage every 4 to 6 weeks. Holiday coverage rotation required. Core service hours subject to change based on business needs.
What you’ll do
Perform level I review for Prior Authorization exception requests according to clinical criteria.
Collect relevant medical and prescription information to support the review of non-formulary exception requests and prior authorization requests.
Set up authorizations and initiating appropriate paperwork and notification process.
Document exception requests status and outcomes in all relevant systems.
Determine customer eligibility, verifying and interpreting pharmacy benefits as required.
Request and review necessary medical records for level II reviews, sending requests with documentation and recommendations to the Assistant Medical Directors for final review.
Contribute to team efficiency by providing support to fellow team members.
Maintain knowledge of Premera health plan policies and benefits, current treatment procedures and alternative resources.
Serve as a resource for other departments for pharmacy program questions.
What you’ll bring
Completion of pharmacy technician training from an accredited Pharmacy Technician program.
Three (3) years' experience as a Pharmacy Technician
Licensure Required: Current, valid State Pharmacy Technician License.
Experience in customer service with both internal and external customers (preferred)
What we offer
Medical, vision and dental coverage
Life and disability insurance
Retirement programs (401K employer match and pension plan)
Wellness incentives, onsite services, a discount program and more
Tuition assistance for undergraduate and graduate degrees
Generous Paid Time Off to reenergize
Equal employment opportunity/affirmative action:
Premera is an equal opportunity/affirmative action employer. Premera seeks to attract and retain the most qualified individuals without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, gender or gender identity, sexual orientation, genetic information or any other protected characteristic under applicable law.
Internal Number: R22959
About Premera Blue Cross
As the largest health plan in the Pacific Northwest, Premera serves more than 2 million people—from individuals and families to employees of Fortune 100 companies.
We provide comprehensive, tailored services to customers in Washington and Alaska that include innovative programs focused on wellness and prevention, disease management, and patient safety. We deliver these programs through health, life, vision, dental, stop-loss, disability, workforce wellness, and other related products and services. Our networks include thousands of doctors, healthcare providers, and hospitals.