Position Type:
PermanentIf you’re looking for a fulfilling career that can make a real difference in your life, and the lives of others, you’ve come to the right place.
As a national health solutions partner, we put people first in everything we do — and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year.
Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest — and it’s reflected in our award-winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today.
The Opportunity
We are seeking a driven, detail-oriented professional to join our dynamic Provider Audit team as an Audit Investigator - Pharmacy. In this critical role, you will leverage advanced audit and analytical tools to identify abnormal claiming patterns within our pharmacy provider network for the company’s drug benefit programs. Your keen investigative skills will be essential in safeguarding the integrity of our programs. You’ll also be expected to build strong, proactive relationships with both service providers and customers, ensuring clear, efficient communication while addressing concerns and providing insights. This is an exciting opportunity to make a meaningful impact while working in an energetic and engaging environment.
Responsibilities
Performing audits of pharmacy providers including: pre-audit and post-audit work; determining the most appropriate course of action based on your findings; compiling findings; and completing final case reports.
Planning, performing, and leading claims audits and other investigative engagements.
Applying query analytics and expert software to profile for indicators of inappropriate claims submissions by pharmacy providers.
Summarizing findings, recommendations, and corrective actions in written reports.
Building, developing and maintaining strong relationships with colleagues and customers, to encourage open dialogue and collaborative commitment to problem solving, continuous improvement, and corporate risk mitigation.
Maintaining a commitment to ongoing learning, developing audit skills in line with best-practice, and building a strong foundation in insurance and healthcare industry principles and knowledge.
Leading and assisting in the performance of other unique risk-based projects.
Requirements
Professional designation as a Pharmacy Technician/ Assistant or professional experience in the pharmaceutical field.
Demonstrated computer skills (including word processing, spreadsheets, flowcharts, etc.).
Excellent initiative, problem solving, and analytical skills.
Ability to articulate thoughts in a clear and concise manner (both verbal and written).
Ability to manage multiple competing priorities and tight deadlines.
Ability to travel across Canada 3-4 weeks per year (non-consecutive).
Valid Driver’s license.
Assets
Knowledge of audit principles, practices and methodologies acquired preferably through 1-3+ years of experience in auditing and/or investigative practices.
Use of data analytics software (e.g. ACL, Excel, etc.), along with an ability to learn and apply statistical inference and data sampling principles to large data populations would be idea.
Professional designation in fraud detection, auditing or investigative techniques (e.g. CPA, CA, CMA, CGA, CIA, CFE, etc.).
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We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs. We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws. We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted.
If you experience any technical issues throughout the application process, please email: Medavie.Recruitment@medavie.ca.
We are committed to hiring military and Veteran spouses and encourage you to identify your connection with the MSEN when reaching out to us or applying to any of our open roles.
Have questions or want to learn more about us? We would love to hear from you!
Kristen Drapeau – Senior Recruitment Consultant
Kristen.Drapeau@medavie.bluecross.ca
Kriysta Duguay – Recruiter
Krysta.Duguay@medavie.bluecross.ca
Welcome to Medavie!
I would be happy to share and discuss our organization, current and future career opportunies.
Many of our roles are able to be remote (work from home) in Canada
- Kristen Drapeau, Senior Recruitment Consultant
-Krysta Duguay, Recruitment Consultant
Who we are
We’re a team of over 8,000 professionals serving clients from coast-to-coast with operations in most provinces. We provide health benefits to nearly 1 in 10 Canadians and manage emergency medical services for nearly 1 in 15 Canadians.
We’ve been a leading health services partner for individuals, employers and governments across Canada for 80 years and a premier all-in-one carrier that provides health, dental, travel, life and disability benefits to individuals and organizations.
We've been recognized as one of Canada's Most Admired Corporate Cultures, one of Canada's Top 100 Employers, and an Imagine Caring Company.
What we value
Our values are inherent to our culture and provide the framework for each interaction we have and transaction we make, while providing a clear set of expectations to empower employees to do the right thing for everyone we serve. We are:
Caring – We show compassion in everything we do
Accountable – We follow through on our commitments
Responsive – We have the courage to act and adapt
Innovative – We encourage and value new ideas
Community-minded – We achieve more together
More than simply a poster on the wall, our mission of improving the wellbeing of Canadians represents the purpose of our organization ― and we align that with our culture.
What we give back
As a not-for-profit organization, we don’t answer to shareholders. Instead, we invest our earnings in our business, our communities and, most importantly, our employees. We use some of these earnings to support:
Programs to support causes that are close to our employees' hearts, matching the volunteer hours and donations they contribute
An annual United Way workplace campaign led by employees in each of our locations
The Medavie Foundation, which invests in community initiatives and organizations that improve the wellbeing of Canadians, focuses on some of the most pressing mental and physical health challenges facing Canadians.
We want to meet you as you are
At Medavie Blue Cross, we foster a culture of openness, understanding and a sense of belonging where everyone can bring their true selves to work. Nearly 70% of our management roles are held by women and we’re committed to creating a diverse, equitable and inclusive workplace where everyone is valued for who they are and what they contribute. We will accommodate people with disabilities during the recruitment, selection and hiring processes.
What we offer
If you live our values and deliver results, you’ll experience meaningful, rewarding work in a purpose-centred, inclusive organization that provides:
Flexible work options: We want you to work where you work best. We offer work from home, from the office, or a hybrid of the two, while ensuring you feel connected to your team and to our purpose. Our flexibility goes beyond location. We also have flexible working hours and part-time options available.
Competitive compensation: We believe in rewarding our employees for the skills they bring to their jobs and the results they deliver. This includes competitive compensation that will reflect your experience and expertise and annual performance-based incentives, a 100% employer-matched defined contribution pension plan, an employee RRSP, one-on-one financial counselling, vacation and personal days to help you rest, refuel and balance your life.
Career Growth: Internal talent mobility and growth are an integral part of our success. Employees are empowered to own their career development and have rewarding experiences in a variety of work areas. Supportive leadership will encourage and coach you to maximize your potential so you can access multiple learning pathways to develop. Our leadership development program and other programs, such as mentoring, performance-based management and education assistance, are offered to provide employees with an environment of lifelong learning.
Outstanding benefits: Wellbeing is at the centre of everything we do and this starts with our employees. To help you take a proactive approach to your health, we provide: