Special Authorization Analyst II – Medications Access

Alberta Blue Cross; Alberta; On-site; CAD 70,000 - 90,000; Full time

Job summary

Alberta Blue Cross is seeking a Special Authorization Analyst II to assess drug coverage requests using evidence-based guidelines and clinical judgment. You will determine eligibility, interpret conditions, and document decisions to support timely access to medications for our 1.8+ million members.

The role emphasizes analytical rigor, accurate decision-making, and clear communication with prescribers and members, while enabling collaboration within a high-energy team environment.

Qualifications

• Knowledge of pharmacotherapy, disease states, treatment guidelines, drug reimbursement principles, and clinical decision-making.
• Preferred experience in Special Authorization, drug benefits administration, pharmacy practice, formulary management, drug utilization review, or health insurance adjudication.
• Strong analytical, problem-solving, and decision-making skills.
• Ability to manage time effectively, work independently, and contribute to a collaborative team environment.
• Excellent written and verbal communication skills, with strong organizational abilities.

Responsibilities

• Apply clinical expertise to assess Special Authorization requests, determine eligibility for drug therapies, and make decisions impacting member access.
• Interpret clinical information, plan criteria, and conditions to ensure accurate, consistent decisions.
• Record decision rationale in Alberta Blue Cross computer systems to support claims adjudication.
• Prepare clinically informed correspondence for prescribers and subscribers regarding Special Authorization decisions.
• Respond to inquiries from internal and external customers with professional, member-focused explanations.
• Work occasional weekdays until 5:00 pm, weekends and statutory holidays on a rotation basis.

Skills

Strong analytical

Problem-solving

Decision-making

Time management

Independent work

Collaborative team player

Written and verbal communication

Organizational abilities

Adaptability

Education

Pharmacy

Pharmacology

Health Sciences

Nursing

Tools

Microsoft Word

Microsoft Excel

Access

Job description

Alberta Blue Cross is seeking a Special Authorization Analyst II to assess drug coverage requests using evidence-based guidelines and clinical judgment. You will determine eligibility, interpret conditions, and document decisions to support timely access to medications for our 1.8+ million members.

The role emphasizes analytical rigor, accurate decision-making, and clear communication with prescribers and members, while enabling collaboration within a high-energy team environment.