Express Scripts Canada

Healthcare

OperationsLeadAnalyst,Fraud,WasteandAbuse

$0–0k Mississauga, Ontario, Canada FULL TIME Remote Friendly
Market Sentiment
HIGH DEMAND

Neural analysis suggests this role is
optimal for Lead candidates.

The Brief

“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.

Healthcare
Problems you'll solve

Critical thinking; Issue resolution

Eligibility Requirements

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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