Auditeur - Management H/F

Status: Full Time

At TELUS Health, we are at the forefront of innovative healthcare solutions in Canada. As a leader in integrated drug, dental, and extended health claims management, we are seeking a detail-oriented Pharmacy Drug Claims Auditor II to join our dynamic team and contribute to the integrity of our pharmacy claims processes.

We are looking for a Pharmacy Drug Claims Auditor II who combines in-depth knowledge of pharmacy operations with sharp analytical skills. This role is ideal for someone with a Pharmacy Technician background who is passionate about diving deep into the complexities of drug claims, identifying discrepancies, and driving process improvements.

Conduct comprehensive audits of pharmacy claims, examining and interpreting pharmacy records against submitted claim data for potential discrepancies

Validate claim documentation and systems data to ensure accurate processing in accordance with contractual and regulatory obligations

Analyze trends in pharmacy claims data to identify patterns, potential fraud, and areas for process improvement

Collaborate with pharmacies, insurance providers, and internal teams to resolve complex claim issues

Develop and implement strategies to enhance the efficiency and accuracy of the claims auditing process

Provide expert guidance on pharmacy-related matters to other departments within TELUS Health

Stay current with pharmacy regulations, drug formularies, and industry best practices

Pharmacy Technician certification with 3+ years of experience in pharmacy operations or claims processing

In-depth understanding of pharmacy drug claims processes, including billing procedures and common discrepancies

Strong analytical and problem-solving skills, with the ability to think critically about complex claims issues

Excellent attention to detail and the ability to manage large volumes of data accurately

Proficiency in data analysis tools and pharmacy management software

Outstanding communication skills, both written and verbal, with the ability to explain technical findings to various audiences

Commitment to continuous learning and staying updated on pharmacy industry trends and regulations

Proficiency in Microsoft Office Suite and Google Suite, including Excel, PowerPoint, Google drive, Google sheets, required

Ability to travel within Canada as needed by the business, required

Bilingual, an asset

Opportunity to apply your pharmacy expertise in a dynamic, technology-driven environment

Flexible work arrangements through our TELUS Work Styles program

Competitive salary and comprehensive benefits package

Continuous learning and development opportunities in healthcare technology and claims management

Collaborative work environment that values innovation and process improvement

If you are ready to leverage your pharmacy background and analytical skills to make a significant impact on the integrity of drug claims processing, we want to hear from you. Join us in our mission to improve healthcare outcomes for Canadians through innovative claims management solutions.

By applying to this role, you understand and agree that your information will be shared with the TELUS Group of Companies' Talent Acquisition team(s) and/or any leader(s) who will be part of the selection process.

Performance Bonus or Sales Incentive Plan: 5% Actual total compensation will be determined based on factors such as knowledge, skills, performance, experience and location. Comprehensive total rewards package highlighting competitive salary and bonus structures, minimum 3 weeks of vacation, and flexible benefits plan to meet the needs of you and your family

Flexibility to work in-office, virtually or a combination of both

Generous company matched pension and share purchase programs

Opportunity to give back to communities in which we work, live and serve

Career growth and learning & development opportunities to develop your skills

We're a people-focused, customer-first, purpose-driven team who works together every day to innovate and do good. We improve lives through our technology solutions and foster a culture of innovation that empowers team members to solve complex problems and create remarkable human outcomes in a digital world.

You'll find our engaging, high-performance culture personally fulfilling, professionally challenging, and financially rewarding. We're committed to diversity and equitable access to employment opportunities based on ability. When you join our team, you're helping us make the future friendly.

Our mission is to improve the way information is being used along the continuum of care to better the health of citizens in Canada and in selected countries.

Disclaimer: In accordance with the TELUS Health Solutions Data Center Security Policy, as a condition of employment, all team members whose job functions require they work at a Data Center and/or have access to detailed knowledge of technology related to client service delivery, are subject to a Personnel Security Screening conducted through the Government of Canada.

The health and safety of our team, customers and communities is paramount to TELUS. Accordingly, we require anyone joining our TELUS Health Care Centres to be fully vaccinated for COVID-19.

Note for Quebec candidates: if knowledge of English is required for this position, it is because the team member will be asked, on a regular basis, to interact in English with external or internal parties or to use English applications or software as part of their tasks.

By applying to this role, you understand and agree that your information will be shared with the TELUS Group of Companies' Talent Acquisition team(s) and/or any leader(s) who will be part of the selection process.