Drug Technical Claims Consultant

The Group Benefits Technical Services Health and Dental Claims Teamis looking for an analytical self-starter to join their team as a Drug Technical Claims Consultant on a regular full-time basis. Reporting to the Manager Health and Dental Claims Operations the Drug Technical Claim Consultant is accountable for providing technical support to various internal and external customers on claims payment practices and procedures.

Position Responsibilities:

• Ensure that Drug Claims are handled in accordance with contractual policy provisions by establishing sound business rules/administrative guidelines for claims adjudication

• Provide technical expertise to internal and external customers to facilitate claims payment resolve escalated complaints manage new issue support etc.

• Provide technical expertise for the development of new product offerings claim initiatives and client customizations that relate to the drug benefit

• Attend client meetings as required

• Attend litigation/arbitration sessions in court

• Accurate release of claims payments up to $80000.00

• Ensure DIN files and drug plans are updated as new drugs formulary and pricing information is introduced

Required Qualifications:

• Post-Secondary education in a related field - pharmacy or nursing background would be an asset

• Thorough knowledge of the Claims admin/payment systems including GIPSY GRID Clients II ESC and V3

• Computer proficiency with MS Word Excel Powerpoint

Preferred Qualifications:

• Understanding of Federal and Provincial Health Care legislation would be an asset

• Excellent understanding of claim administrative procedurescontractual provisions and drug product offerings

• Excellent written/oral communication/customer service skills

• Good presentation and negotiation skills

• Strong analytical research problem-solving and decision-making skills

• Effective project management capabilities

• Ability to review and analyze critical data to make formal recommendations for process improvements

• General understanding of medical terminology diseases and drug formularies

• Comfortable speaking with external parties such as pharmacists health care providers drug manufacturers government agencies plan members and plan sponsors etc.

• Must be able to decipher health industry information and understand how it relates to Group Benefits plans

• Proven ability to manage/schedule a fluctuating unpredictable workload

• General understanding of all Group Benefits departments

When you join our team:

• Well empower you to learn and grow the career you want.

• Well recognize and support you in a flexible environment where well-being and inclusion are more than just words.

• As part of our global team well support you in shaping the future you want to see.

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About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider helping people make their decisions easier and lives better. To learn more about us visit is an Equal Opportunity Employer

At Manulife/John Hancock we embrace our diversity. We strive to attract develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment retention advancement and compensation and we administer all of our practices and programs without discrimination on the basis of race ancestry place of origin colour ethnic origin citizenship religion or religious beliefs creed sex (including pregnancy and pregnancy-related conditions) sexual orientation genetic characteristics veteran status gender identity gender expression age marital status family status disability or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process contact .

Referenced Salary Location

Salary range is expected to be between

If you are applying for this role outside of the primary location please contact for the salary range for your location. The actual salary will vary depending on local market conditions geography and relevant job-related factors such as knowledge skills qualifications experience and education/training. Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance.

Manulife offers eligible employees a wide array of customizable benefits including health dental mental health vision short- and long-term disability life and AD&D insurance coverage adoption/surrogacy and wellness benefits and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in Canada includes holidays vacation personal and sick days and we offer the full range of statutory leaves of absence. If you are applying for this role in the U.S. please contact for more information about U.S.-specific paid time off provisions.