Job Title: Fraud, Waste and Abuse Operations Lead AnalystLocation: 300 – 6985 Financial Drive Mississauga OntarioEmployment Type: Contract 1 YearReason for Vacancy: ReplacementWork Arrangement: HybridDepartment Name: Fraud, Waste and AbusePay Type: SalariedPay Range: $60,000-$68,000. Please note that this is a general posting range and offer range will be varied based on relevant experience, qualifications, skills required and location for this role.About UsExpress Scripts Canada (ESC) is a leading health benefits management company. Serving over 12 million members, we help insurance carriers, third party administrators, and the public sector optimize the value of health benefits by linking the talent and professional expertise of our people with leading edge information management systems and technology. ESC is a wholly owned subsidiary of Express Scripts Inc., one of the largest pharmacy benefit management (PBM) companies in North America, part of The Cigna Group (NYSE: CI), a global health company. Together, we deliver innovative, cost-effective solutions that improve access, affordability, and health outcomes for Canadians.Job Summary:The Operations Lead Analyst is responsible for administering operational efficiency processes that manage cost and optimize results, including financial data analysis and reporting as part of the Fraud, Waste and Abuse Program (FWA). The Operations Lead Analyst presents opportunities and findings both verbally and in writing to key internal and external stakeholders, including coordinating and providing updates to private and public sector customers and internal team(s) as necessary. The successful candidate will be involved in multiple projects and collaborate with department supervisors, managers and colleagues both in FWA and other cross functional departments. This is an exciting opportunity for an adaptable candidate to gain experience and exposure to the administrative, financial and reporting operations of the FWA department.Key Responsibilities:Produce financial reports for clients and provide insights into trendsResponsible for provider electronic withhold entries for audit recoveries for all benefits and monitor electronic withhold to satisfy timely audit recoveriesCollect and analyze quality assurance data for public sector client meetings and internal metricsEnsure alignment and consistency of delivery of program between all benefitsIdentify emerging trends and create presentations for clients to support audit result meetingsWork with both internal and external stakeholders to address client inquiries, gather, collect information,



for deliverablesConduct monthly quality assurance review of staff time trackersCreate and maintain forecasting tools for oversight on key performance indicators and emerging trendsOversee program training documents, SOPs, and working instructions. Ensure processes are mapped out, outlined and organized for team to utilizeLead quality-focused remedial training sessions for team. Assist managers with maintaining training recordsIdentify, lead and manage special projects and program initiativesContinuously seek opportunities to create efficiencies within processes and drive value for the programResolve non-routine issues escalated from other team membersTasks involve a degree of forward planning and anticipation of needs/issuesOther duties as assignedQualificationsPost secondary degree or equivalent work experience3+ years of related experience in Pharmacy and/or Dental Benefits Management, Group Insurance or Health Care OperationsDemonstrated experience in quality assurance activities, data analysis, and reportingHighly proficient in Microsoft Access & Excel, and data warehousing applicationsExperience with compiling, manipulating or validating large pieces of dataAbility to maintain electronic filing systemsDisplay high levels of curiosity, integrity, tact and objective judgementExcellent organizational, planning and critical thinking skillsExcellent verbal and written communication skills, including ability to present to clients and internal stakeholdersProven interpersonal skills and ability to work well with senior management and high-level external contacts handling sensitive or confidential information is criticalAbility to work with minimum management oversight on multiple projects with competing prioritiesAbility to work a flexible schedule in high pressure environments with urgent deadlinesProven time and resource management skills; detail oriented with strong organizational abilitiesWhy Join Us?Competitive compensation, benefits and pension planCareer development and advancement opportunitiesA culture that celebrates innovation and collaborationFlexible work options and wellness programsPre-Employment RequirementsAll offers of employment are conditional upon the successful completion of reference checks and background verification in accordance with company policy. Within ESC, for certain positions,



obtaining and maintaining a federal government security clearance is a condition of employment. Candidates applying for such roles must meet all eligibility criteria for the applicable clearance level and consent to the security screening process as mandated by federal regulations. Failure to obtain or maintain the required clearance will result in withdrawal of the offer or termination of employment.Our hiring process includes AI-powered tools to conduct video interviews, take notes and score candidates; however, all scores will be reviewed by hiring managers and our Talent team before making a decision.Express Scripts Canada is a Cigna companyExpress 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 CanadaExpress 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 workplace. We provide Active PharmacyTM 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.It will be a condition of employment that the successful candidate obtains an Enhanced Reliability Clearance from the Federal Government. The candidate will be required to provide supporting documentation to receive clearance if required.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.

📌 Fraud, Waste And Abuse Operations Lead Analyst - 12 Months Contract - Express Scripts Canada (Mississauga)
🏢 Cigna Healthcare
📍 Mississauga