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Clinical Services Associate
3 weeks ago
The Clinical Services Associate works closely with Clinical Pharmacists to manage the clinical formularies and programs. The Associate has a critical role in administering prior authorization requests, answering clinical questions from both internal and external clients, and retrieving and analyzing drug claims reports.
**ESSENTIAL FUNCTIONS**:
- Assist clinical pharmacists in the day-to-day management of clinical formularies and programs.
- Administer and review Prior Authorization requests according to service level agreement with external customers.
- Retrieve and organize new Notice of Compliance information from Health Canada
- Manage the Clinical Services team mailbox and answer enquiries from both internal and external customers on issues including drug coverage, claims adjudication, formularies and programs, and provincial pharmacy legislation. Queries may lead to claims analyses, collaboration with cross-functional teams, and subsequent provision of recommendations to improve internal work processes, ensure alignment with legislation, and enforce ESC program philosophy.
- Prepare, organize, and distribute meeting materials for the Drug Evaluation Committee. Presentation of the materials is also required.
- Run and analyze drug claims for clinical programs and business projects. Support plan modeling requests as required.
- Assist drug plan management specialists with formulary updates.
- Assist with strategic initiatives and product development. This involves research, information gathering and data organization.
- Act as a resource for other ESC teams including Drug Plan Management, Drug Database, Marketing, and Customer Services.
**QUALIFICATIONS**:
- Bachelor’s degree in Science related field
- Completion of pharmacy technician course (preferred)
- Pharmacy technician background - minimum 2 years in retail pharmacy or equivalent
- Bilingual (French and English) an asset
- Pharmacy benefit management experience considered an asset
- Microsoft Word, Excel, Access, Outlook and PowerPoint
- Knowledge of other computer systems considered an asset
- Strong knowledge of pharmacy laws and regulations
- Experience with drugs names, drug schedules, pharmacy resources
- Excellent Customer Service skills
- Comfortable speaking with clients and other health care professionals (doctors, nurses, etc.)
- Able to multi-task and prioritize work
- Strong focus on accuracy
**Express Scripts Canada is a Cigna company**
Express Scripts Canada is a subsidiary of Express Scripts, a Cigna company. Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, wellbeing and peace of mind of those we serve. Cigna offers an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioural health, pharmacy, vision, supplemental benefits, and other related products.
**About Express Scripts Canada**
Express Scripts Canada is a leading health benefits manager and has been recognized as one of the most innovative. Our clients include Canada's leading insurers, third party administrators and governments. We work with these clients to develop industry-leading solutions to deliver superior healthcare in a cost-controlled environment. We provide Active Pharmacy services to more than 7 million Canadian patients and adjudicate more than 100 million pharmacy, dental, and extended health claims annually. Through our proprietary consumer intelligence, clinical expertise, and patients-first approach, we promote better health decisions for plan members, while managing and reducing drug benefit costs for plan sponsors.
We offer a competitive salary and benefits package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment.
We are an equal opportunity employer that promotes a diverse, inclusive and accessible workplace. By embracing diversity, we build a more effective organization that empowers our employees to be the best that they can be.
We are committed to creating a working environment that is barrier-free and we are prepared to provide accommodation for people with disabilities.
