Hybrid Drug Claims Investigator – Fraud & Analytics

Manulife; Toronto; Hybrid; CAD 51,000 - 86,000; Full time

Job summary

A leading financial services provider is seeking a Drug Investigation Analyst to join their team in Toronto. The ideal candidate will investigate and prevent fraud in drug claims and provide analytical support to ensure the integrity of benefits programs. Key responsibilities include data analysis, conducting interviews, and leading investigations. Applicants with a pharmacy assistant or technician background are preferred. A hybrid working arrangement is offered, with a competitive salary range of CAD 51,375 to CAD 85,625.

Benefits

Health and dental benefits

Mental health support

Retirement savings plans

Paid time off

Qualifications

• Knowledge of medical terminology and drug formularies.
• Ability to decipher health industry information.
• Demonstrated investigation skills with attention to detail.

Responsibilities

• Perform data profiling to identify risk trends.
• Lead investigations to successful conclusions.
• Conduct interviews of plan members and service providers.
• Review high dollar drug claims for analysis.

Skills

Attention to detail

Problem solving

Customer service

Data analysis

Presentation skills

Negotiation skills

Project management capabilities

Research skills

Communication skills

Education

Post-Secondary education (pharmacy assistant/technician background)

Tools

Excel

Data mining software

Job description

A leading financial services provider is seeking a Drug Investigation Analyst to join their team in Toronto. The ideal candidate will investigate and prevent fraud in drug claims and provide analytical support to ensure the integrity of benefits programs. Key responsibilities include data analysis, conducting interviews, and leading investigations. Applicants with a pharmacy assistant or technician background are preferred. A hybrid working arrangement is offered, with a competitive salary range of CAD 51,375 to CAD 85,625.