At St Luke's Health Plan our dedicated team strives to build a positive, supportive, and inclusive culture that delivers exceptional member experiences.
The Utilization Management Pharmacy Technician is responsible for resolving complex and high-impact benefit issues involving prior authorizations, step therapy, appeals, and denied claims. This role requires deep knowledge of pharmacy benefit design, high-cost medications, and payer policies. The Utilization Management Pharmacy Technician works with the clinical pharmacist to support both members and providers by navigating challenging benefit issues and serves as a trusted internal resource for technical and policy-related guidance. This position works collaboratively across multiple teams within the health plan and system and supports all lines of business, including government-funded programs.
What You Can Expect:
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Schedule: Monday-Friday business hours, hybrid position
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Make a meaningful impact on member care by using your pharmacy expertise to evaluate prior authorizations, resolve medication access challenges, and support appeals that help members receive the medications they need.
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Grow your clinical and operational knowledge while partnering with pharmacists and cross-functional teams on formulary updates, regulatory compliance, and pharmacy benefit decisions that shape member care.
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Expand your skills and influence by serving as a trusted resource for pharmacy operations, contributing to training and process improvements, and participating in projects that enhance workflows and the member experience.
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Be part of a collaborative, fast-paced team where you'll help maintain service excellence by supporting help desk operations, managing priority work, and ensuring timely, high-quality responses across the department.
Qualifications:
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Education: HS Diploma/GED
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Experience: Three (3) years' relevant experience
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Licenses/Certifications: Valid Idaho Pharmacy Technician license
