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.
Green Shield Canada (GSC) is not your traditional health and dental benefits provider. We’re different, and that’s a good thing.
As Canada’s fourth largest health benefits provider, GSC 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 GSC’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.
HBM+ is a business unit within GSC and is more than a pharmacy benefits manager, it is a health benefits manager. With offices in Quebec and Ontario, HBM+ provides customized white-label solutions that support drug, dental and extended health benefits for group benefits carriers, third-party payors, and government organizations across Canada.
HBM+ is built on a foundation of proven technology, seamless branding, innovative claim management and administration capabilities, collaborative provider management, and solid industry expertise. They recognize that each client is unique and requires a business solution tailored to their needs.
THE ROLE IN A NUTSHELL
Base Salary: CAD $59,688.00 - 91,109.00
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Conduct on‑site and desk audits of pharmacy providers to verify compliance with Pharmacy Benefit Management (PBM) agreements.
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Review pharmacy claims and dispensing records for accuracy and regulatory adherence.
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Analyze large datasets to identify trends, anomalies, and potential risk indicators.
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Research and report on health benefit utilization trends; develop provider profiling criteria.
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Identify cost‑containment opportunities and support financial recovery efforts.
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Prepare audit reports outlining findings, financial impact, and corrective actions.
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Communicate findings to internal teams and pharmacy providers; support remediation efforts.
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Serve as a subject‑matter expert on pharmacy operations, claims adjudication, and PBM reimbursement.
WHO WE'RE LOOKING FOR
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Experience in pharmacy auditing, drug claim processing, PBM operations, healthcare analytics, or related fields.
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Knowledge of pharmacy claims, dispensing practices, regulatory requirements, and drug pricing structures.
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Proficiency with Excel, SQL, or other analytical tools used for data review and reporting.
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Strong written communication skills, including the ability to prepare clear and comprehensive audit reports.
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Ability to manage multiple audits simultaneously and meet established deadlines.
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High level of integrity with strict adherence to confidentiality and compliance standards.
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Strong interpersonal skills with the ability to communicate effectively with internal and external stakeholders at all levels, both verbally and in writing.
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Analytical mindset with experience interpreting complex data structures, identifying business problems, and supporting process‑improvement solutions.
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Demonstrated ability to meet objectives and milestones independently
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Highly organized, with the ability to manage multiple audits simultaneously in a fast‑paced environment.
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Ability to travel within Canada as required.
NICE TO HAVE
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Certified Pharmacy Technician (CPhT) or equivalent pharmacy experience
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Bilingual (English and French) - Asset.
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Experience with pharmacy claims systems
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A Certified Fraud Examiner (CFE) certificate.
GSC is committed to providing accommodations for applicants with disabilities. If you require an accommodation please contact [email protected] and we will work with you to meet your needs.
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).
AI Usage - GreenShield leverages AI to help produce Job Descriptions, and ideate on interview questions. We also leverage AI for interview transcription support.
