Audit Investigator- Pharmacy
Audit Investigator- Pharmacy
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Job Description
Position Type:
PermanentIf youre looking for a fulfilling career that can make a real difference in your life and the lives of others youve 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 8000 professionals who bring a crosssection of diverse life experiences and career expertise to Medavie. By collaborating and innovating together our employees are creating industryleading 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 its reflected in our awardwinning 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 detailoriented 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 companys drug benefit programs. Your keen investigative skills will be essential in safeguarding the integrity of our programs. Youll 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: preaudit and postaudit 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 bestpractice and building a strong foundation in insurance and healthcare industry principles and knowledge.
Leading and assisting in the performance of other unique riskbased 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 34 weeks per year (nonconsecutive).
Valid Drivers license.
Assets
Knowledge of audit principles practices and methodologies acquired preferably through 13 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: .
Employment Type
Full-Time
