Analyst, Payor Performance

1 month ago

Toronto, Canada Shoppers Drug Mart Pharmaprix Full time

**Location**:
243 Consumers Road, Toronto, Ontario, M2J 4W8

At Shoppers Drug Mart, we’re innovating health and wellness in Canada. From prescriptions to walk-in clinics, and a beloved loyalty program, we’re caring and supporting our customers in new ways every day.
With more than 1,300 locally owned and operated stores from coast to coast, the Shoppers Drug Mart network is more than a great place to shop, it’s a great place to work. We’re committed to building our talented team who champion collaboration, kindness and inclusivity. Join our team, and help recognize a healthy future for your career and for all Canadians.

**Why this role is important?**

**OVERVIEW**:
Reporting to the Senior Manager, Payor Performance, this role will be responsible for supporting the Payor Performance team’s requirements and initiatives and the overall departmental goal of protecting and enhancing Pharmacy revenues and margins. The **Analyst**, Payor Performance** will help Shoppers Drug Mart and Loblaw stores coordinate appeal responses to Third Party Payor auditors/inspectors, review appeal decisions for disputes, and provide general support to stores.

**DUTIES AND RESPONSIBILITIES**:

- Develop and execute the Payor Performance team’s goals and objectives by coordinating appeal responses to Third Party Payor auditors and inspectors on behalf of both Shoppers Drug Mart and Loblaw stores
- Support and maintain the appeal workflow for the Payor Performance team, including but not limited to reporting, monitoring, documentation gathering, results tracking
- Develop an extensive understanding of Third Party Payors in relation to adjudication issues, pharmacy manuals and audit processes
- Provide guidance on and assist in the resolution of issues that have been escalated from store-level and support teams relating to private and public payor audits and appeals
- Provide general support to stores and follow up with store pharmacy teams to communicate appeal results
- Support development of education and training documents related to Pharmacy Third Party Payors and their processes
- Monitor team shared mailbox and respond accordingly
- Provide administrative support related to Pharmacy Payors as required
- Support and collaborate on cross-functional pharmacy projects, as required
- Support ad-hoc pharmacy special projects to improve our pharmacy processes nationwide

**SKILLS AND EXPERIENCE**:

- A minimum of 1-3 years pharmacy experience, preferably in a retail, private payor, or audit environment
- Pharmacy Assistant/Technician certification or Undergraduate degree preferred, a degree in Healthcare or Analytics would be considered an asset
- Pharmacy Management System experience considered an asset (e.g., KROLL, HealthWATCH)
- An understanding of Third Party Payor drug plans, adjudication, and appeal processes as well as an understanding of pharmacy regulatory requirements, CHLIA guidelines, and CPhA Pharmacy Claim Standard is considered an asset
- Proficiency in Microsoft Office (Word, Excel, PowerPoint, etc.) to produce documents and reports
- High level of initiative to take projects from start to finish with mínimal supervision
- Strong problem-solving ability and attention to detail
- Ability to work well independently and in a team environment
- Excellent time management and organizational skills
- Excellent verbal and written English communication skills. Ability to clearly communicate verbally and in writing to varying audiences
- Ability to work well independently and in a team environment

**Why work at Shoppers Drug Mart?**

Acting as consultants, supporting internal customers and the Associate-Owners, you will get experience unique to the retail industry while working for an award-winning national brand. Benefit from a purchase discount program, competitive pay and online learning through _Academy_.

Take ownership of your work and find more ways to care about your work, co-workers, customers and community.

**How You’ll Succeed**:
At Shoppers Drug Mart Inc., we seek great people to continually strengthen our culture. We believe great people model our values, are authentic, build trust and make connections.

**Employment Type**:
Full time

**Type of Role**:
Regular

Shoppers Drug Mart Inc. recognizes Canada’s diversity as a source of national pride and strength. We have made it a priority to reflect our nation’s evolving diversity in the products we sell, the people we hire, and the culture we create in our organization. Accommodation is available upon request for applicants with disabilities in the recruitment and assessment process and when hired.

In addition, we believe that compliance with laws is about doing the right thing. Upholding the law is part of our Code of Conduct - it reinforces what our customers and stakeholders expect of us.

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