Express Scripts Canada
Healthcare
OperationsLeadAnalyst,Fraud,WasteandAbuse
Neural analysis suggests this role is
optimal for Lead candidates.
“Operations Lead Analyst, Fraud, Waste and Abuse at Express Scripts Canada. Skills: Financial reporting, Data analysis. Administer operational efficiency processes. Manage cost and optimize results”
What You'll Achieve.
Optimize results; Satisfy timely audit recoveries; Support audit result meetings; Drive value for the program
Industry & Context.
Critical thinking; Issue resolution
Federal government security clearance, Video interviews, AI-powered tools
What They're Looking For.
Must Have
Post secondary degree or equivalent work experience, 3+ years related experience, Proficient in Microsoft Access & Excel, Experience compiling, manipulating or validating data, Ability to maintain electronic filing systems, Excellent organizational, planning and critical thinking skills, Excellent verbal and written communication skills, Proven interpersonal skills, Ability to work with minimum management oversight, Ability to work a flexible schedule, Proven time and resource management, Enhanced Reliability Clearance from Federal Government
Nice to Have
Experience in Pharmacy and/or Dental Benefits Management, Experience in Group Insurance or Health Care Operations
What You'll Do.
Administer operational efficiency processes
Manage cost and optimize results
Perform financial data analysis
Generate financial reports for clients
Provide insights into trends
Perform provider electronic withhold entries
Monitor electronic withhold for audit recoveries
Collect quality assurance data
Analyze quality assurance data
Ensure alignment of program delivery
Identify emerging trends
Create presentations for clients
Address client inquiries
Gather information for deliverables
Conduct monthly quality assurance review
Create forecasting tools
Maintain forecasting tools
Oversee program training documents
Oversee working instructions
Organize processes for team
Lead remedial training sessions
Assist managers with training records
Lead special projects
Manage special projects
Lead program initiatives
Manage program initiatives
Seek opportunities for efficiencies
Drive value for the program
Resolve non-routine issues
Plan for future needs
Anticipate future issues
How You'll Work.
Team & Collaboration
Cross functional departments; Internal stakeholders; External stakeholders; Senior management; High-level external contacts
Communication Scope
Present to clients; Present to stakeholders; Verbal communication; Written communication
Process & Methodology
Special projects, Program initiatives
Full Job Description
**Job Title:** Fraud, Waste and Abuse Operations Lead Analyst **Location:** 300 – 6985 Financial Drive Mississauga Ontario **Employment Type:** Contract 1 Year **Reason for Vacancy:** Replacement **Work Arrangement:** Hybrid - 2 days in office required **Department Name:** Fraud, Waste and Abuse **Pay Type:** Salary **Pay Range:** $32.00 - $37.00 Please note that this is a general posting range and offer range will be varied based on relevant experience, qualifications, skills required and location for this role. **About Us** Express Scripts Canada (ESC) is a leading health benefits management company. Serving over 12 million members, we help insurance carriers, third party administrators, and the public sector optimize the value of health benefits by linking the talent and professional expertise of our people with leading edge information management systems and technology. ESC is a wholly owned subsidiary of Express Scripts Inc., one of the largest pharmacy benefit management (PBM) companies in North America, part of The Cigna Group (NYSE: CI), a global health company. Together, we deliver innovative, cost-effective solutions that improve access, affordability, and health outcomes for Canadians. **Job Summary:** The Operations Lead Analyst is responsible for administering operational efficiency processes that manage cost and optimize results, including financial data analysis and reporting as part of the Fraud, Waste and Abuse Program (FWA). The Operations Lead Analyst presents opportunities and findings both verbally and in writing to key internal and external stakeholders, including coordinating and providing updates to private and public sector customers and internal team(s) as necessary. The successful candidate will be involved in multiple projects and collaborate with department supervisors, managers and colleagues both in FWA and other cross functional departments. This is an exciting opportunity for an adaptable candidate to gain experience and exposure to
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