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Provider Relations Reporting Specialist At Express Scripts

Location: Mississauga, Ontario

Job Description

The role of Provider Relations is to manage provider contracts and registration to ensure an accurate database and to support healthcare providers by delivering effective and timely communications to ensure seamless claims adjudication.


Express Scripts Canada is looking for a self-motivated and energetic Provider Relations Reporting Specialist. The primary functions of this role are to assist the Provider Relations team with introducing a workforce assignment to maintain service levels, monitoring of productivity and quality results, and other reporting duties to support client requirements and department objectives. The role also requires the successful candidate to perform Quality Assurance (QA) functions including verifying communication postings on the provider Website for the Non-Insured Health Benefits (NIHB) program.


Key Responsibilities:


  • Develop new and maintain existing reports and initiatives within Provider Relations and Operations
  • Track key metrics for reporting, communication and forecasting
  • Create workforce assignment and forecast based on service commitments and available capacity
  • Produce productivity and quality reports
  • Conduct ongoing capacity reviews as business needs change to understand workforce resource requirements
  • Analyze trends, present findings and recommendations/insights to management and follow through to implementation of solutions
  • Assist the Manager with reporting required to support Sr. Management and Customer needs, as well as other department initiatives (e.g. external audits)
  • Perform Quality Assurance (QA) activities including verifying the accuracy of communication postings on the Provider Website, and support the Provider Relations QA and Communications Specialists as necessary (e.g. backfill during vacation periods)
  • Maintain up to date process documentation for all operational functions
  • Support training of existing employees and on boarding for new employees
  • Support company projects and perform system testing for the department
  • Other duties as assigned

Qualifications:


  • Post -Secondary School diploma or Bachelor’s degree in Information Systems or related field, or equivalent work experience
  • Minimum of 2 years related experience in business analysis and reporting including the ability to gather clear business requirements
  • Strong organizational and time management skills
  • Detail oriented
  • Excellent interpersonal skills
  • Ability to work effectively within a team and independently, and work cross-functionally as required
  • Advanced skills in Microsoft Office applications, specifically Excel, Access and/or SQL, and workforce metrics
  • Familiarity with business intelligence tools and/or creating and maintaining dashboards of Key Performance Indicators
  • Familiarity with Microsoft Office macros or VBA
  • Knowledge of managed healthcare/pharmacy, MS&E or Dental benefit administration and claims processing is an asset
  • Bilingualism in French & English is an asset

ABOUT EXPRESS SCRIPTS CANADA


Express Scripts Canada, a registered business name of ESI Canada, an Ontario partnership indirectly controlled by Express Scripts, Inc. (Nasdaq: ESRX), is one of Canada’s leading providers of health benefits management services. From its corporate headquarters in Mississauga, Ontario, just outside Toronto, Express Scripts Canada provides a full range of integrated pharmacy benefit management (PBM) services to insurers, third-party administrators, plan sponsors and the public sector, including health-claims adjudication and processing services, Home Delivery Pharmacy Services, benefit-design consultation, drug-utilization review, formulary management, and medical and drug-data analysis services, to better facilitate the best possible health outcomes at the lowest possible cost.


It will be a condition of employment that the successful candidate receives the Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation in order to receive Clearance if required.


We offer a competitive salary, 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. Thank you for your interest in this position, however only qualified candidates will be contacted for an interview. No telephone calls please.


For more information about Express Scripts Canada, visit its Web site at www.express-scripts.ca.


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