Drive excellence in managing complex Prior Authorization claims at Manulife. This hybrid role demands skilled case management and direct communication with members and providers in a customer-focused environment.
As a Drug Prior Authorization Case Manager, you'll autonomously manage intricate claims while ensuring top-tier service. A deep understanding of drug requests, clinical guidelines, and extensive research is essential. Your expertise will directly support various stakeholders, providing critical guidance and mentorship.
Key Responsibilities:
• Oversee the complete lifecycle of complex drug claims
• Communicate results to members, providers, and pharmacies
• Research and resolve non-standard authorization scenarios




• Support internal teams with Prior Authorization guidance
• Manage escalated claims issues proactively
Requirements:
• Post-secondary education or relevant experience
• 2-3 years in case management or claims environment
• Proficiency in Microsoft Office 365 applications
• Knowledge of medical terminology and benefits administration
• Robust analytical and communication skills
Enhance the customer experience and become a subject matter expert at Manulife.
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📌 Prior Authorization Case Manager at Manulife (Waterloo Regional Municipality)
🏢 Manulife group
📍 Waterloo Regional Municipality