Pharmacy Specialist

Workforce Classification:

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 are fostering a culture that emphasizes employee growth, collaborative innovation, and inspired leadership. We are dedicated to creating an environment where employees can excel and where top talent is attracted, retained, and thrives. As a testament to these efforts, Premera has been recognized on the 2025 America's Dream Employers list. In 2024, Newsweek honored Premera as one of America's Greatest Workplaces, America's Greatest Workplaces for Diversity, and America's Greatest Workplaces for Mental Wellbeing. Additionally in 2024, Forbes ranked Premera among America’s Best Midsize Employers for the fourth time.

Learn how Premera supports our members, customers and the communities that we serve through our Healthsource blog:  https://healthsource.premera.com/.

As a Pharmacy Services Specialist I, you will play a pivotal role in supporting Pharmacy Service Operations and Pharmacy Programs, ensuring both provider and customer satisfaction. Your responsibilities will include completing prior authorization review requests from providers, performing level I reviews for Prior Authorization exception requests according to clinical criteria, and collecting relevant medical and prescription information to support the review of non-formulary exception requests and prior authorization requests. 

Schedule:

Core service hours: Monday through Friday 7:30 AM to 5:00 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.

What you’ll do:

Support the Pharmacy Prior Authorization Program by:

• Performing level I review for Prior Authorization exception requests according to clinical criteria.
• Collecting relevant medical and prescription information to support the review of non-formulary exception requests and prior authorization requests.
• Setting up authorizations and initiating appropriate paperwork and notification process.
• Documenting exception requests status and outcomes in all relevant systems.
• Determining customer eligibility, verifying and interpreting pharmacy benefits as required.
• Requesting and reviewing 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.
• Other duties as assigned.

What you’ll bring:

• Current and valid State Pharmacy Technician License (Required).
• Three (3) years' experience as a Pharmacy Technician (Required).
• Experience in customer service with both internal and external customers.
• Completion of pharmacy technician training from an accredited Pharmacy Technician program.
• Prior health insurance experience preferred.

Premera total rewards

Our comprehensive total rewards package provides support, resources, and opportunities to help employees thrive and grow. Our total rewards are more than a collection of perks, they're a reflection of our commitment to your health and well-being. We offer a broad array of rewards including physical, financial, emotional, and community benefits, including:

• Medical, vision, and dental coverage with low employee premiums.

• Voluntary benefit offerings, including pet insurance for paw parents.

• Life and disability insurance.

• Retirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.

• Wellness incentives with a wide range of mental well-being resources for you and your dependents, including counseling services, stress management programs, and mindfulness programs, just to name a few.

• Generous paid time off to reenergize.

• Looking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.

• Employee recognition program to celebrate anniversaries, team accomplishments, and more.

For our hybrid employees, our on-campus model provides flexibility to create your own routine with access to on-site resources, networking opportunities, and team engagement.

• Commuter perks make your trip to work less impactful on the environment and your wallet.

• Free convenient on-site parking.

• Subsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.

• Engaging on-site events and activities include food trucks, health and wellness, DEI and disaster preparedness fairs, coffee connects, and more.

• Our complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.

• Need a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.

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 careers@premera.com or via phone at 425-918-4785.

Premera is hiring in the following states, with some limitations based on role or city: Alaska, Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Iowa, Kansas, Kentucky, Maine, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin.

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.

The salary range for this role is posted below; we generally target up to and around the midpoint of the range.

National Salary Range:

National Plus Salary Range:

*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.

We’re happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. We’re committed to creating a diverse and inclusive environment where all employees are celebrated for their unique skills and contributions.