Fraud, Waste and Abuse Operations Lead Analyst Employment Type: Contract 1 Year Reason for Vacancy: Replacement Department Name: Fraud, Waste and Abuse 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.

Express 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. one of the largest pharmacy benefit management (PBM) companies in North America, part of The Cigna Group (NYSE: CI), a global health company.

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.





Collect and analyze quality assurance data for public sector client meetings and internal metrics Conduct monthly quality assurance review of staff time trackers Create and maintain forecasting tools for oversight on key performance indicators and emerging trends Oversee program training documents, SOPs, and working instructions. Lead quality-focused remedial training sessions for team. Assist managers with maintaining training records Identify, lead and manage special projects and program initiatives Tasks involve a degree of forward planning and anticipation of needs/issues Post secondary degree or equivalent work experience ~3+ years of related experience in Pharmacy and/or Dental Benefits Management, Group Insurance or Health Care Operations ~ Demonstrated experience in quality assurance activities, data analysis, and reporting ~ Highly proficient in Microsoft Access & Excel, and data warehousing applications ~ Experience with compiling, manipulating or validating large pieces of data ~ Excellent organizational, planning and critical thinking skills ~ Proven interpersonal skills and ability to work well with senior management and high-level external contacts handling sensitive or confidential information is critical ~ Ability to work with minimum management oversight on multiple projects with competing priorities ~ Ability to work a flexible schedule in high pressure environments with urgent deadlines ~ Proven time and resource management skills; Competitive compensation, benefits and pension plan Flexible work options and wellness programs All 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. Our hiring process includes AI-powered tools to conduct video interviews, take notes and score candidates; 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. We provide Active Pharmacy™ 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.

We offer a competitive salary and perks package, along with a positive work environment built on solid corporate values, integrity, mutual respect, collaboration, passion, service and alignment. 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.

If you require accommodation in completing the online application process, please email: eschr2@express-scripts.

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