{"id":3546077,"url":"https://alion.io/job/premera-manager-pharmacy-utilization-management","title":"Manager, Pharmacy Utilization Management","company":{"id":18095,"name":"Premera","domain":"premera.com","url":"https://alion.io/company/premera","size_band":"501-1000","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"B","score":75,"open_postings":4,"ghost_share":0,"stale_share":1,"repost_share":0,"time_to_fill_p50_days":47,"computed_at":"2026-11-03T05:54:40Z"}},"role":"HR","role_family":"HR","seniority":"junior","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Mountlake Terrace, United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":150300,"max":270500,"currency":"USD","period":"year","gross":null,"usd_annual":270500},"salary_estimate":null,"experience_years_min":2,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Outlook","optional":false}],"status":"live","first_seen_at":"2026-10-30T20:46:11Z","employer_posted_date":"2026-10-30","last_verified_at":"2026-11-03T20:47:16Z","board_verified":true,"closed_at":null,"days_open":4,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":4},"description":"Workforce Classification:\nHybridJoin Our Team: Do Meaningful Work and Improve People’s Lives\nOur 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.\nPremera is committed to being a workplace where people feel empowered to grow, innovate, and lead with purpose. By investing in our employees and fostering a culture of collaboration and continuous development, we’re able to better serve our customers. It’s this commitment that has earned us recognition as one of the best companies to work for. Learn more about our recent awards and recognitions as a greatest workplace.\nLearn how Premera supports our members, customers and the communities that we serve through our Healthsource blog: https://healthsource.premera.com/.\nAbout the role of the Manager, Pharmacy Utilization Management\nThe Manager, Pharmacy Utilization Management is a newly created leadership role that brings together clinical expertise and operational leadership to help shape the future of Pharmacy Utilization Management (UM) at Premera. This role offers the opportunity to connect the department’s strategic direction with the evolving needs of its review operations, supporting a more unified approach across pharmacy benefit and medical benefit drugs. You’ll help position Pharmacy UM for its next phase as workforce models, workflows, and technology evolve.\nWhat you’ll do:\nOversee day-to-day activities of the team, including staff management, achieving department goals and team effectiveness.\nEnsure clinical programs, operations and consulting focus effectively delivers on the strategic direction of Premera's Pharmacy Program while meeting the needs of customers. \nDevelop and maintain monitoring and ongoing improvement strategy for pharmacy clinical programs, operations, or consulting. Areas of focus may include:\nDrug Utilization Management/Prior Authorization across Medical and Pharmacy benefit\nQuality accreditation reporting and documentation and required procedures for pharmacy.\nPharmacy benefit manager (PBM) and other vendor set-up, testing and issue resolution\nSpecialty pharmacy set-up, testing and escalated specialty pharmacy customer issues.\nFormulary Program and Formulary Promotions, including oversight of Pharmacy and Therapeutics (P&T) Committee\nResponsible for hiring, performance management, training, and professional development of team.\nProvide clinical training, and business support of pharmacy and medical management strategies and solutions to Sales and Marketing Department including sales of the pharmacy benefit to clients (current and prospective clients)\nContribute to and manage completion of pharmacy and clinical/medical management content in Request for Proposals (RFPs).\nComplete special projects and other duties as assigned.\nAs part of this role, you may be assigned internal controls derived from Premera’s internal controls framework. You will be accountable for understanding the controls assigned to you, their impacts on Premera, and to ensure that they are operating effectively.\nWhat you’ll bring:\nPharmacist with an advanced degree (e.g. PharmD, MBA, MHA, MPH). (Required)\nActive state Pharmacist License. (Required)\nSix (6) years’ of pharmacy experience with at least two (2) years’ experience focused in any combination of the following: clinical program development, pharmacy consulting experience working in a Pharmacy Benefit Management (PBM) or in a health plan. (Required)\nCompletion of the American Society of Health-System Pharmacists ASHP-accredited residency program. (Preferred)\nExperience with project management. (Preferred)\nExperience in a managed care pharmacy. (Preferred)\nDemonstrated ability to lead and manage multiple, complex, concurrent projects or teams.\nAbility to communicate effectively verbally and in writing; strong presentation skills.\nProven ability to build and maintain relationships with both internal and external individuals.\nStrong analytical skills; Demonstrated experience analyzing trends and making recommendations based on the analysis.\nWorking knowledge of local and regional health care issues.\nAbility to work independently, as well as a member of a team.\nIntermediate MS Word, Excel, PowerPoint and Outlook skills.\nLEAN program/process experience/certification, Six Sigma experience/certification or other process improvement program experience/certification.\nPremera total rewards\nOur 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:\nMedical, vision, and dental coverage with low employee premiums.\n\nVoluntary benefit offerings, including pet insurance for paw parents.\n\nLife and disability insurance.\n\nRetirement programs, including a 401K employer match and, believe it or not, a pension plan that is vested after 3 years of service.\n\nWellness 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.\n\nGenerous paid time off to reenergize.\n\nLooking for continuing education? We have tuition assistance for both undergraduate and graduate degrees.\n\nEmployee recognition program to celebrate anniversaries, team accomplishments, and more.\n\nFor 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.\nCommuter perks make your trip to work less impactful on the environment and your wallet.\n\nFree convenient on-site parking.\n\nSubsidized on-campus cafes make lunchtime connections with colleagues fun and affordable.\n\nParticipate in engaging on-site activities such as health and wellness events, coffee connects, disaster preparedness fairs and more.\n\nOur complementary fitness & well-being center offers both in-person and virtual workouts and nutritional counseling.\n\nNeed a brain break? Challenge someone to a game of shuffleboard or ping pong while on campus.\n\nEqual employment opportunity/affirmativeaction:\nPremera is an equal opportunity/affirmativeaction 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.\nIf you need an accommodation to apply online for positions at Premera, please contact Premera Human Resources via email at  or via phone at 425-918-4785.\nThe 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.\nThe salary range for this role is posted below; we generally target up to and around the midpoint of the range.\n National Plus Salary Range:\n$150,300.00 - $270,500.00*National Plus salary range is used in higher cost of labor markets including Western Washington and Alaska.\nWe’re happy to discuss compensation further during the interview because we believe that open communication leads to better outcomes for all. 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