Medication Reimbursement Specialist - TGH OP

Union: Non-Union

New or Replacement: Replacement

Site: Toronto General Hospital

Department: Outpatient Pharmacy

Reports to: Manager

Wage Range: $35.28 - $44.10 per hour

Hours: 37.5 Hours per Week

Shifts: Monday to Friday

Status: Temporary Full-Time (12 Month Contract)

Closing Date: October 22, 2026

Position Summary

As an integral member of the Toronto General Hospital Outpatient Pharmacy team the primary focus of the Medication Reimbursement Specialist is to facilitate and coordinate the submission of application forms for access to medication assistance for outpatients. This job will serve as the centralized point of contact for physicians, nurses, social workers and pharmacists, and, will be actively involved with government, community based and private agencies that provide financial assistance for medications. He/she will serve as an advisor to patients, families and health care providers regarding medication access and reimbursement.
Duties
Communicate with patients, prescribers, healthcare professionals and other stakeholders to support patients through their treatment journey
Verify and investigate insurance coverage and benefits for patients, including eligibility, co-payments, deductibles, and prior authorizations.
Gather and document information from patients/caregivers/prescribers in a concise, organized and professional manner
Complete, submit and follow-up on requisite paperwork in a timely manner
Liase with private and public insurance providers to determine coverage options
Act as a central liaison for stakeholders such as physicians, pharmacists, nurses, other allied healthcare partners, patients, and clinics and provide required updates
Maintain confidentiality of patient healthcare and financial information
Keep up-to-date with changes in insurance coverage and reimbursement policies, and communicate these changes to healthcare providers and patients.

At minimum, completion of a two year community college program in an Allied Health related discipline or recognized equivalent required
At minimum, two years practical and related experience
Minimum of 2 years’ experience in outpatient pharmacy or related setting
Knowledge and experience with public and private medication access/reimbursement programs and relevant agencies
Advanced knowledge of pharmaceutical, or insurance industry
Strong analytical and mathematical skills
Ability to communicate effectively both verbally and in writing
Effective interpersonal and leadership skills
Effective organizational skills; attention to detail
Ability to consistently meet deadlines
Excellent problem-solving skills; ability to resolve issues effectively and efficiently

Why join UHN?

In addition to working alongside some of the most talented and inspiring healthcare professionals in the world, UHN offers a wide range of benefits, programs and perks. It is the comprehensiveness of these offerings that makes it a differentiating factor, allowing you to find value where it matters most to you, now and throughout your career at UHN.
Competitive offer packages
Government organization and a member of the Healthcare of Ontario Pension Plan (HOOPP
Close access to Transit and UHN shuttle service
A flexible work environment
Opportunities for development and promotions within a large organization
Additional perks (multiple corporate discounts including: travel, restaurants, parking, phone plans, auto insurance discounts, on-site gyms, etc.)

Current UHN employees must have successfully completed their probationary period, have a good employee record along with satisfactory attendance in accordance with UHN's attendance management program, to be eligible for consideration.

All applications must be submitted before the posting close date.

UHN uses email to communicate with selected candidates. Please ensure you check your email regularly. At University Health Network (UHN), artificial intelligence technologies may be used to assist in the screening, assessment, and selection of candidates for this position.

Please be advised that a Criminal Record Check may be required of the successful candidate. Should it be determined that any information provided by a candidate be misleading, inaccurate or incorrect, UHN reserves the right to discontinue with the consideration of their application.

UHN is an equal opportunity employer committed to an inclusive recruitment process and workplace. Requests for accommodation can be made at any stage of the recruitment process. Applicants need to make their requirements known.

We thank all applicants for their interest, however, only those selected for further consideration will be contacted.