Supervisor, Pharmacy Claims Audit - Mississauga, Canada - Cigna

Cigna

Verified Company

Mississauga, Canada

2 weeks ago

Posted by:

Sophia Lee

beBee Recruiter

Description

Supervisor, Pharmacy Claims Audit

ESSENTIAL FUNCTIONS:

Lead the pharmacy audit team

Provide coaching, training and oversight of the department to ensure high quality service that will meet both internal and external needs

Identify, recommend and develop strategic initiatives to improve quality, and streamline and enhance operations so the team can detect and address risk in a timely manner

Ensure standardization of practice throughout the team, while ensuring proper workflow and process management

Ensure that systems, procedures and personnel are available to efficiently provide audit services to meet our customer expectations and departmental objectives

Ensure client commitments are met, and present audit findings and recommendations to internal and external customers

Communicate effectively with internal and external stakeholders based on the needs of the business

Schedule and track all day-to-day audit activities of the team and monitor audit findings to ensure effective resolution

Streamline the production of department reports as required and distribute to appropriate personnel and clients

Review customer reporting and billing to identify accurate capture of revenues, evaluation of recoveries and generation of insights for adapting audit practices

Ensure the timely resolution of internal and external escalations

Support the team in their development - create and maintain a high functioning team while recommending career advancement opportunities

Resolve employee issues and disputes using effective conflict resolution strategies, including direct communication between the parties involved so they can come to a mutually acceptable resolution

Develop problem solving capabilities within the team to empower them and elevate team performance

QUALIFICATIONS:

5+ years of experience in a hospital, community pharmacy setting, or experience in group benefits including pharmacy benefits

Governance, regulatory and/or audit experience required

Knowledge of provincial and federal pharmacy regulations and legislative requirements

Prior managerial experience is preferred

Ability to coach/train, motivate, give and receive feedback in a constructive manner

Ability to people manage and develop talent

Demonstrated interpersonal skills to facilitate change management

Team player and ability to work cross-functionally with other departments

Excellent time and resource management skills

Self-driven, curious, ability to work independently with mínimal supervision

Proven ability to manage competing priorities in a fast-based environment

Strong focus on quality and accuracy

Strong focus on customer service and presentation skills

Detail-oriented with proven high-level oral and written communication skills

Demonstrates and applies integrity in all aspects of work

Knowledge of Microsoft Office software (Word, Excel and PowerPoint)

Job requires precise finger/hand movements while working with a keyboard

Ability to work in an open work station environment

Need to remain at work station for lengthy periods

Ability to travel to quarterly and annual client meetings

Express Scripts Canada is a Cigna company
Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company

Cigna Corporation (NYSE:
CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve.

Cigna offers an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products.

About Express Scripts Canada
Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment.

We provide Active Pharmacy services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually.

Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.

We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.

We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace.

By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.

We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.