SPECIALIST – PBM SOLUTIONS (HYBRID - CONTRACT)
Top Benefits
About the role
GreenShield is no longer just a traditional health and dental benefits provider. We’re growing and evolving to have an even bigger impact!
With a starting point as Canada’s fourth largest health benefits provider, GreenShield manages and administers benefit plan programs for nearly four million plan participants nation-wide. As a not-for-profit social enterprise, we are driven by our Purpose: to make it easier for people to live their healthiest lives. And we’re fully committed to the talented team of employees who delight our clients and set our organization apart as an industry leader.
We are also proud to have been selected by Waterstone Human Capital as one of Canada’s Most Admired Corporate Cultures™. This award confirms GreenShield’s longstanding reputation as a company that respects and engages its employees – one that provides an excellent working environment and offers challenges and career growth.
WHY GREENSHIELD IS A GREAT PLACE TO WORK
With all our cutting-edge solutions, there’s never a dull moment
Our approach to offering and managing health benefits is always forward-thinking, from the promotion of digital mental health therapies (such as Inkblot) to predictive modelling of claims data insights, and the use of AI in our industry-leading Claim Watch™ fraud detection and prevention strategy.
We invest in our employees
As we grow, so do our employees. We offer training and professional development to ensure employees excel and are well positioned for career advancement within GreenShield. We encourage our team to continue their education – and we help fund it.
You’re part of something bigger
As a social enterprise, we re-invest our profits to support local communities and advocate to make it easier for Canadians to live their healthiest lives. Our employees – and customers – benefit from knowing they are contributing to enhancing the common good.
We don’t stop there. Check out these other perks:
- Generous time off (including vacation, holiday shutdown between Christmas and New Year, and having your birthday off)
- Full and flexible benefits on day one (it is our business after all)
- Convenient commute accessibility (…if we ever commute again!)
THE ROLE IN A NUTSHELL
- Execute formulary listing decisions as confirmed by our Pharmacy & Therapeutics Committee to internal and external stakeholders.
- Supports automation of P&T operational processes to promote efficient end to end processing from drug submission to formulary listing.
- Manages system implementation for all drug policies as well as all pharmacy products, services, and associated programs.
- Performs and summarizes industry scans of innovative Pharmacy Benefit Manager (PBM) technologies and policies for presentation to the pharmacy team leadership.
- Support the maintenance of pharmacy applications (including web apps and APIs).
- Translate the pharmacy department’s strategic objectives into actionable IT requirements through scoping and system implementation.
- Participate in user acceptance testing (UAT) and provide final sign-off on system enhancements related to drug benefit changes.
- Provide responsive, solution-based support to internal teams for system related inquiries that aid sales and implementation.
- Identifies testing requirements for system changes to implement new policies or projects.
- Requests, creates and/or analyzes reporting as required.
- Supports pharmacy, claims, and call centre leadership with escalation resolution.
WHAT WE’RE LOOKING FOR
- A University Degree or College Diploma is required.
- Experience with health benefits and/or claims administration systems and processes.
- Able to navigate ambiguity, overcome confusion, and simplify complex situations.
- Energetic self-starter, with a strong sense of accountability and ownership - you’re an investigator, and not afraid to keep digging into information to answer questions like “why,” “how,” and “so what.”
- Great organizational and time management skills with the ability to multitask.
- Excellent communication and presentation skills both to internal and external stakeholders with a passion for customer satisfaction.
- Effective in developing relationships and contributing to team performance in a highly collaborative environment.
- Demonstrated ability to handle confidential information.
- Able to work with minimal supervision.
- Proficiency in MS Office Suite
NICE TO HAVE
- Experience in pharmacy benefit management
- Experience working in a community pharmacy
- Strong working knowledge of the regulatory and competitive environment for prescription drugs and pharmacy benefits; awareness and ability to anticipate key trends.
- Proficient in using Business Objects WEBI and writing queries in SQL for data extraction, analysis, and reporting.
- Knowledge of low-code/no-code automation platforms.
- Keen interest in AI-driven technologies and robotic process automation (RPA) solutions
About Green Shield Canada
GreenShield is an integrated health services organization and the first organization in Canada to operate as a payer-provider – offering insurance, administering benefits, and paying claims as a ‘payer’, while offering medical, mental health and pharmacy services as a ‘provider’. This model allows GreenShield to build care around Canadians, simplify their health care experience, and improve health outcomes.
GreenShield is uniquely structured as a not-for-profit social enterprise. We reinvest earnings and redeploys services to underserved Canadian communities via our social impact brand, GreenShield Cares, with a focus on positively impacting at least one million Canadians by 2025. As the industry’s noble challenger GreenShield continues to innovate, evolving its offerings and services to deepen our purpose of championing Better Health for All.
SPECIALIST – PBM SOLUTIONS (HYBRID - CONTRACT)
Top Benefits
About the role
GreenShield is no longer just a traditional health and dental benefits provider. We’re growing and evolving to have an even bigger impact!
With a starting point as Canada’s fourth largest health benefits provider, GreenShield manages and administers benefit plan programs for nearly four million plan participants nation-wide. As a not-for-profit social enterprise, we are driven by our Purpose: to make it easier for people to live their healthiest lives. And we’re fully committed to the talented team of employees who delight our clients and set our organization apart as an industry leader.
We are also proud to have been selected by Waterstone Human Capital as one of Canada’s Most Admired Corporate Cultures™. This award confirms GreenShield’s longstanding reputation as a company that respects and engages its employees – one that provides an excellent working environment and offers challenges and career growth.
WHY GREENSHIELD IS A GREAT PLACE TO WORK
With all our cutting-edge solutions, there’s never a dull moment
Our approach to offering and managing health benefits is always forward-thinking, from the promotion of digital mental health therapies (such as Inkblot) to predictive modelling of claims data insights, and the use of AI in our industry-leading Claim Watch™ fraud detection and prevention strategy.
We invest in our employees
As we grow, so do our employees. We offer training and professional development to ensure employees excel and are well positioned for career advancement within GreenShield. We encourage our team to continue their education – and we help fund it.
You’re part of something bigger
As a social enterprise, we re-invest our profits to support local communities and advocate to make it easier for Canadians to live their healthiest lives. Our employees – and customers – benefit from knowing they are contributing to enhancing the common good.
We don’t stop there. Check out these other perks:
- Generous time off (including vacation, holiday shutdown between Christmas and New Year, and having your birthday off)
- Full and flexible benefits on day one (it is our business after all)
- Convenient commute accessibility (…if we ever commute again!)
THE ROLE IN A NUTSHELL
- Execute formulary listing decisions as confirmed by our Pharmacy & Therapeutics Committee to internal and external stakeholders.
- Supports automation of P&T operational processes to promote efficient end to end processing from drug submission to formulary listing.
- Manages system implementation for all drug policies as well as all pharmacy products, services, and associated programs.
- Performs and summarizes industry scans of innovative Pharmacy Benefit Manager (PBM) technologies and policies for presentation to the pharmacy team leadership.
- Support the maintenance of pharmacy applications (including web apps and APIs).
- Translate the pharmacy department’s strategic objectives into actionable IT requirements through scoping and system implementation.
- Participate in user acceptance testing (UAT) and provide final sign-off on system enhancements related to drug benefit changes.
- Provide responsive, solution-based support to internal teams for system related inquiries that aid sales and implementation.
- Identifies testing requirements for system changes to implement new policies or projects.
- Requests, creates and/or analyzes reporting as required.
- Supports pharmacy, claims, and call centre leadership with escalation resolution.
WHAT WE’RE LOOKING FOR
- A University Degree or College Diploma is required.
- Experience with health benefits and/or claims administration systems and processes.
- Able to navigate ambiguity, overcome confusion, and simplify complex situations.
- Energetic self-starter, with a strong sense of accountability and ownership - you’re an investigator, and not afraid to keep digging into information to answer questions like “why,” “how,” and “so what.”
- Great organizational and time management skills with the ability to multitask.
- Excellent communication and presentation skills both to internal and external stakeholders with a passion for customer satisfaction.
- Effective in developing relationships and contributing to team performance in a highly collaborative environment.
- Demonstrated ability to handle confidential information.
- Able to work with minimal supervision.
- Proficiency in MS Office Suite
NICE TO HAVE
- Experience in pharmacy benefit management
- Experience working in a community pharmacy
- Strong working knowledge of the regulatory and competitive environment for prescription drugs and pharmacy benefits; awareness and ability to anticipate key trends.
- Proficient in using Business Objects WEBI and writing queries in SQL for data extraction, analysis, and reporting.
- Knowledge of low-code/no-code automation platforms.
- Keen interest in AI-driven technologies and robotic process automation (RPA) solutions
About Green Shield Canada
GreenShield is an integrated health services organization and the first organization in Canada to operate as a payer-provider – offering insurance, administering benefits, and paying claims as a ‘payer’, while offering medical, mental health and pharmacy services as a ‘provider’. This model allows GreenShield to build care around Canadians, simplify their health care experience, and improve health outcomes.
GreenShield is uniquely structured as a not-for-profit social enterprise. We reinvest earnings and redeploys services to underserved Canadian communities via our social impact brand, GreenShield Cares, with a focus on positively impacting at least one million Canadians by 2025. As the industry’s noble challenger GreenShield continues to innovate, evolving its offerings and services to deepen our purpose of championing Better Health for All.