Special Authorization Analyst II – Clinical Drug Services

This is a fully remote position, open to applicants in Canada.

📋 Description

• Evaluate Special Authorization requests and assess eligibility for the requested medication therapies

• Utilize evidence-based guidelines, clinical judgment, and member needs to inform medication coverage decisions

• Analyze clinical data, recognized medical conditions, and plan criteria

• Document decision rationale and necessary information in the Alberta Blue Cross computer systems

• Facilitate appropriate claims processing and ensure continuity of member access

• Draft clinically informed communications for prescribers and subscribers

• Address electronic and telephone inquiries from both internal and external clients

• Articulate decision outcomes, requirements, and next steps in a professional and member-centered approach

⛳️ Requirements

• Preferred post-secondary education in Pharmacy, Pharmacology, Health Sciences, Nursing, or similar clinical fields

• Experienced Pharmacy Technicians and current special authorization professionals may be eligible

• Understanding of pharmacotherapy, disease states, treatment guidelines, drug reimbursement principles, and clinical decision processes

• Preferred experience in Special Authorization, drug benefits administration, pharmacy operations, formulary management, drug utilization review, or health insurance adjudication

• Strong analytical, problem-solving, and decision-making capabilities

• Ability to effectively manage time and work both independently and collaboratively

• High level of accuracy and attention to detail

• Proficiency in Microsoft Office, including Word and Excel

• Experience with Access is considered an asset

• Excellent written and verbal communication skills

• Strong organizational skills

• Ability to adapt to shifting priorities and handle competing demands

• Service-oriented and responsive, with a talent for building and maintaining effective customer relationships

• Willingness to work occasional weekdays until 5:00 pm, weekends, and statutory holidays on a rotating basis

• A satisfactory criminal record check is required as a condition of employment following a conditional offer

🏝️ Benefits

• Healthy work-life balance

• Opportunities for career advancement

• Innovative, high-energy, team-oriented work environment

• Inclusive workplace that appreciates diversity and unique perspectives