Analyste technique de régimes - poste bilingue/ Bilingual Client Benefits Technical Analyst – E[...]

Express Scripts by Evernorth; Montreal; On-site; CAD 80,000 - 140,000; Full time

Job summary

An established health benefits manager is seeking a Bilingual Client Benefits Technical Analyst to provide technical support to clients regarding health benefits. This role involves liaising with insurance companies and third-party administrators, ensuring excellent customer relationships, and supporting clinical programs. The ideal candidate will possess strong analytical skills and be proficient in both French and English. Join a dynamic team that values collaboration and innovation in a supportive work environment, where your contributions will help shape the future of healthcare services in Canada.

Qualifications

• University degree or college diploma or equivalent experience required.
• Bilingual in French and English is essential.

Responsibilities

• Provide technical expertise on health benefits inquiries.
• Act as a liaison between customers and internal departments.
• Train customers on various applications.

Skills

Bilingual (French and English)

Customer Service

Analytical Skills

Problem Solving

Multitasking

Communication Skills

Education

University Degree or College Diploma

Tools

Microsoft Office Suite

Job description

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L’analyste technique de régimes agit à titre de personne-ressource auprès de nos clients, des assureurs et des tiers administrateurs lorsqu’ils formulent des requêtes ou éprouvent des difficultés en matière de régimes de soins de santé. L’analyste technique de régimes s’assurera de maintenir d’excellentes relations avec les clients. L’équipe du Service à la clientèle fournit le soutien relatif à la couverture des régimes d’assurance médicaments, de soins dentaires et de soins médicaux complémentaires. Elle fournit également le soutien relativement à toute question liée aux bases de données, aux services informatiques et au traitement des demandes de règlement, et effectue la coordination avec d’autres services afin de soutenir pleinement les clients.

RESPONSABILITÉS PRINCIPALES

• Fournir une expertise technique relativement aux questions des clients sur les régimes d’assurance médicaments, de soins dentaires et de soins médicaux complémentaires, ainsi que sur le traitement des demandes de règlement et les paiements.
• Fournir le soutien à l’équipe des Services cliniques d’Express Scripts Canada relativement à la mise en place de programmes cliniques (nouveaux ou actuels), de listes de médicaments ainsi que de nouveaux produits en lien avec le développement des affaires.
• Fournir le soutien aux chargés de comptes relativement aux divers projets stratégiques, aux communications et à la promotion de produits d’Express Scripts Canada sur le marché.
• Fournir des analyses de répercussions aux clients, au besoin.
• Agir à titre d’agent de liaison entre les clients et d’autres services au sein d’Express Scripts Canada, Et travailler en étroite collaboration avec ces services pour déterminer les besoins des clients et y répondre.
• Organiser diverses réunions avec les clients et les collaborateurs internes et y participer.
• Former les clients et les collaborateurs internes sur les diverses applications.
• Fournir un appui aux spécialistes du soutien à la clientèle (Centre d’appels).

COMPÉTENCES RECHERCHÉES

• Être titulaire d’un diplôme universitaire ou collégial, ou posséder l’expérience équivalente.
• Être bilingue (français et anglais), à l’oral comme à l’écrit est essentiel.
• Posséder de l’expérience dans le domaine de l’assurance collective, des régimes d’assurance médicaments, de soins dentaires ou de soins médicaux complémentaires.
• Posséder de l’expérience à titre de technicien en pharmacie ou des connaissances des régimes provinciaux d’assurance médicaments (Programme de médicaments de l’Ontario, listes provinciales de médicaments, RAMQ) constituent un atout.
• Posséder d’excellentes aptitudes en service à la clientèle.
• Posséder de solides capacités d’analyse, de raisonnement et de résolution de problème.
• Faire preuve d’initiative.
• Être en mesure de gérer plusieurs tâches à la fois et d’établir les priorités en fonction des urgences.
• Être en mesure de travailler efficacement autant avec les clients qu’avec les personnes-ressources à l’interne comme à l’extérieur.
• Présenter d’excellentes habiletés de communication à l’oral comme à l’écrit.
• Maîtriser les applications logicielles (suite Microsoft Office).

The primary function of the Client Benefit Technical Analyst is to act as a key point of contact for all Health Benefit inquiries and issues for our customers – insurance companies and third party administrators (TPAs). The Client Benefit Technical Analyst will ensure that relationships with our customers are effectively maintained. The Customer Services team provides support to customers on Pharmacy, Dental and Health plans coverage. The team also provides customer support on various database, IT, adjudication inquiries, and coordinating with other departments to fully support customers

Essential Functions

• Provide technical expertise on Drug, Dental & Extended Health Benefits related issues as requested by customers, such as claim adjudication and payment questions.
• Support ESC Clinical team with the implementation of new and existing clinical programs, formularies, and new business development products.
• Provide support to Account Managers on various strategic initiatives, communications and promotion of Express Scripts Canada’s products to the marketplace.
• Support customers with impact analysis as needed.
• Act as the liaison between the customer and other Express Scripts Canada departments and work closely alongside these internal operational representatives to identify and resolve customer needs.
• Facilitate and attend various meetings with customers and internal partners.
• Train customers and internal partners on various applications.
• Provide back up to Customer Support Specialist (Call Centre).

Qualifications

• University Degree, College Diploma or Equivalent experience
• Bilingual in French and English written and verbal is a must
• Experience in the field of Group Insurance, Pharmacy, Dental or Health Benefits Plans
• Pharmacy technician background and/or knowledge of government drug programs (Ontario Drug Benefits, Provincial Formularies, RAMQ) is an asset
• Excellent Customer Service capabilities
• Demonstrates strong analytical, critical thinking and problem solving skills
• Shows initiative
• Ability to multitask and prioritize based on urgency
• Able to work effectively with both internal/external customers and internal/external contacts
• Excellent verbal and written communication skills
• Proficient with computer applications (MS Office)

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: [e-mail] Do not email [e-mail] for an update on your application or to provide your resume as you will not receive a response.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Information Technology

• Industries

  Hospitals and Health Care

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