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Pharmacy Services Specialist I

Company

Premera Blue Cross
Address , Remote
Employment type FULL_TIME
Salary $47,000 - $70,500 a year
Expires 2023-07-14
Posted at 1 year ago
Job Description
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.
Forbes ranked Premera among America’s 2022 Best Midsize Employers
because we are committed to creating an environment where employees can do their best work and where best-in-class talent comes, stays, and thrives!
COVID-19 Vaccination Policy:
To learn more about our COVID-19 vaccination and accommodation requirements, please visit our Careers landing page.
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.
Schedule:
Core service hours: Monday through Friday 7:30 AM to 6:00 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.
This is a virtual/telecommuter role, working from home.
What you’ll do:
  • Document exception requests status and outcomes in all relevant systems.
  • Maintain knowledge of Premera health plan policies and benefits, current treatment procedures and alternative resources.
  • Complete pharmacy prior authorization review requests from providers.
  • Set up authorizations and initiating appropriate paperwork and notification process.
  • Contribute to team efficiency by providing support to fellow team members.
  • Serve as a resource for other departments for pharmacy program questions.
  • Determine customer eligibility, verifying and interpreting pharmacy benefits as required.
  • Collect relevant medical and prescription information to support the review of non-formulary exception requests and prior authorization requests.
  • Request and review necessary medical records for Level II reviews, sending requests with documentation and recommendations to the Assistant Medical Directors for final review.
  • Perform Level I review for Prior Authorization exception requests according to clinical criteria.
What you’ll bring:
  • (3) years of experience as a Pharmacy Technician. (Required)
  • Current, valid Washington State Pharmacy Technician License. (Required)
#LI-REMOTE
What we offer
  • Retirement programs (401K employer match and pension plan)
  • Generous Paid Time Off to reenergize
  • Free parking
  • Life and disability insurance
  • Wellness incentives, onsite services, a discount program and more
  • Medical, vision and dental coverage
  • Tuition assistance for undergraduate and graduate degrees
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.
If you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at [email protected] or via phone at 425-918-4785.
The pay for this role will vary based on a range of factors including, but not limited to, a candidate’s geographic location, market conditions, and specific skills and experience.
National Salary Range:
$41,600.00 - $62,400.00
National Plus Salary Range:
$47,000.00 - $70,500.00
  • National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.