SPECIALIST – PBM SOLUTIONS (HYBRID - 12 MONTHS CONTRACT)

Green Shield


Date: 23 hours ago
City: Toronto, Ontario
Contract type: Full time

WHO WE ARE
When it comes to health, we’re always looking for ways to push for better. It’s why we were founded in the first place. In 1957, our founder, pharmacist William Wilkinson, witnessed a mother sacrifice her health by forgoing her own medicine to pay for her sick daughter’s prescription. He knew there had to be a better way. So, he introduced North America’s first prepaid drug plan, and GreenShield was born as a not-for-profit with a mission to support better health for all Canadians.

We aren’t just a health and benefits company. We’re the only not-for-profit social enterprise that brings worlds of coverage and care together, all in one place.
We’re noble challengers, purposefully building a better way and we need the best people to help us create a more holistic approach that takes care of the mind and body.

Our mission is to create better health for all Canadians, and we know that starts with our employees.

THE ROLE IN A NUTSHELL


GreenShield is no longer just a traditional health and dental benefits provider. We’re growing and evolving to have an even bigger impact!


With a starting point as Canada’s fourth largest health benefits provider, GreenShield manages and administers benefit plan programs for nearly four million plan participants nation-wide. As a not-for-profit social enterprise, we are driven by our Purpose: to make it easier for people to live their healthiest lives. And we’re fully committed to the talented team of employees who delight our clients and set our organization apart as an industry leader.


We are also proud to have been selected by Waterstone Human Capital as one of Canada’s Most Admired Corporate Cultures. This award confirms GreenShield’s longstanding reputation as a company that respects and engages its employees – one that provides an excellent working environment and offers challenges and career growth.


WHY GREENSHIELD IS A GREAT PLACE TO WORK


With all our cutting-edge solutions, there’s never a dull moment
Our approach to offering and managing health benefits is always forward-thinking, from the promotion of digital mental health therapies (such as Inkblot) to predictive modelling of claims data insights, and the use of AI in our industry-leading Claim Watch fraud detection and prevention strategy.


We invest in our employees

As we grow, so do our employees. We offer training and professional development to ensure employees excel and are well positioned for career advancement within GreenShield. We encourage our team to continue their education – and we help fund it.


You’re part of something bigger


As a social enterprise, we re-invest our profits to support local communities and advocate to make it easier for Canadians to live their healthiest lives. Our employees – and customers – benefit from knowing they are contributing to enhancing the common good.


We don’t stop there. Check out these other perks:

Generous time off (including vacation, holiday shutdown between Christmas and New Year, and having your birthday off)
Full and flexible benefits on day one (it is our business after all)
Convenient commute accessibility (…if we ever commute again!)

THE ROLE IN A NUTSHELL


  • Execute formulary listing decisions as confirmed by our Pharmacy & Therapeutics Committee to internal and external stakeholders.
  • Supports automation of P&T operational processes to promote efficient end to end processing from drug submission to formulary listing.
  • Manages system implementation for all drug policies as well as all pharmacy products, services, and associated programs.
  • Performs and summarizes industry scans of innovative Pharmacy Benefit Manager (PBM) technologies and policies for presentation to the pharmacy team leadership.
  • Support the maintenance of pharmacy applications (including web apps and APIs).
  • Translate the pharmacy department’s strategic objectives into actionable IT requirements through scoping and system implementation.
  • Participate in user acceptance testing (UAT) and provide final sign-off on system enhancements related to drug benefit changes.
  • Provide responsive, solution-based support to internal teams for system related inquiries that aid sales and implementation.
  • Identifies testing requirements for system changes to implement new policies or projects.
  • Requests, creates and/or analyzes reporting as required.
  • Supports pharmacy, claims, and call centre leadership with escalation resolution.

WHO WE'RE LOOKING FOR


WHAT WE’RE LOOKING FOR

  • A University Degree or College Diploma is required.
  • Experience with health benefits and/or claims administration systems and processes.
  • Able to navigate ambiguity, overcome confusion, and simplify complex situations.
  • Energetic self-starter, with a strong sense of accountability and ownership - you’re an investigator, and not afraid to keep digging into information to answer questions like “why,” “how,” and “so what.”
  • Great organizational and time management skills with the ability to multitask.
  • Excellent communication and presentation skills both to internal and external stakeholders with a passion for customer satisfaction.
  • Effective in developing relationships and contributing to team performance in a highly collaborative environment.
  • Demonstrated ability to handle confidential information.
  • Able to work with minimal supervision.
  • Proficiency in MS Office Suite

  • NICE TO HAVE
  • Experience in pharmacy benefit management
  • Experience working in a community pharmacy
  • Strong working knowledge of the regulatory and competitive environment for prescription drugs and pharmacy benefits; awareness and ability to anticipate key trends.
  • Proficient in using Business Objects WEBI and writing queries in SQL for data extraction, analysis, and reporting.
  • Knowledge of low-code/no-code automation platforms.
  • Keen interest in AI-driven technologies and robotic process automation (RPA) solutions

THE CULTURE
We believe a career should be meaningful. Not just a means to earn a living. Our culture is one where everyone's voice is heard and valued. Because that’s what it takes to create better health for all. We dare to challenge the status quo. And we’re driven by people who have challenged theirs. We believe that your workplace should empower you to be the best version of yourself. That’s why we provide a place where you can be inspired, challenged, and rewarded.

Where your growth means our growth.
Where your voice is heard and valued.
Where your work has purpose. And purpose matters.

We believe our people are critical to our overall success. Inclusivity makes us a stronger, smarter and more informed organization. Being intentionally inclusive of diverse backgrounds, perspectives and experiences will enhance our company culture to positively impact how we support our communities. A career at GreenShield isn’t just about personal achievements, it's about making a difference together.

Here’s to Better Health for All!

A FEW MORE DETAILS
Proficiency in English is required for this position. As part of this role, you will be required to communicate with colleagues or customers who use English as their primary language. By requiring English proficiency for this position, we aim to ensure that our employees can excel in their roles, collaborate, and communicate effectively, and contribute to the success of our organization.

GS supports diversity, equity and inclusion in our teams and communities, and we value the unique contributions made by all. Even if your experience doesn’t align perfectly to every requirement, we invite you to apply. We encourage applications from all candidates and will accommodate needs under human rights legislation throughout all stages of the recruitment and selection process. Please let us know of any accommodation through [email protected]. Information received relating to accommodation will be addressed confidentially.

Providing this information gives GS consent to use your personal information to assess your suitability for specific positions, future opportunities or for your personnel file. Your résumé will be held in strict confidence and will be viewed only by the Organization. Information may be stored outside of Canada and could be used for aggregate statistical purposes (which uses no personal identification).

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