POSITION SUMMARY:
Through the work of the Drug Pricing Services team, Express Scripts Canada offers its customers access to a comprehensive drug product and price file database of drug identification numbers (DINs) and drug prices for drug claim adjudication. The primary function of the Provider Data Analyst is to update and maintain the master drug file and the provincial price files for ESC customers using their knowledge and experience from retail pharmacy.
Delivers specific delegated tasks assigned by a supervisor in the Provider Data job family.
Responsible for accurate, timely maintenance of complex provider information and synchronization of data on all claims and provider databases including expertise on business requirements for multiple business regions.
Participates in the design of data tracking and monitoring tools.
Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes.
Validates data to be housed on provider databases and ensure adherence to business and system requirements of customers.
Researches, resolves complex exceptions and error reports, determine regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules.
Interprets update requests and coordinates with internal and external customer to clarify and complete. Contributes to completion of projects and programs in area of expertise.
Completes day-to-day Provider Data tasks without immediate supervision, but has ready access to advice from more experienced team members.
Tasks involve a degree of forward planning and anticipation of needs/issues.
Resolves non-routine issues escalated from more junior team members.
ESSENTIAL FUNCTIONS:
Performs the scheduled tasks required to maintain the product and price information for drug and medical supplies & equipment items in each province and territory
Uses documented processes to apply provincial coverage data and price changes from the source files for each field in the database and prepare the data for upload.
Performs peer review and quality assurance checks in the application following the data change
Prepares the price and coverage data required for custom programs
Resolves and responds to Provider and Customer queries regarding information in the database
Analyzes price and provincial program changes for impact to customer benefit plans
Identifies trends and opportunities for process improvements and efficiencies
QUALIFICATIONS:
High School diploma.
Graduate from a Pharmacy Technician/Assistant program
Effective organizational and time management skills to meet firm turnaround times
Critical thinking for decision making
Ability to work individually and in a team setting
Meticulous attention to detail
Advanced MS Excel skills
Superior analytical and problem-solving skills
Bilingualism (French & English) is an asset
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.
It will be a condition of employment that the successful candidate obtains an Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation to receive clearance if required.
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.
If you require accommodation in completing the online application process, please email:
[email protected] Do not email
[email protected] for an update on your application or to provide your resume as you will not receive a response.
