Fraud, Waste and Abuse Operations Lead Analyst - 12 Months Contract - Express Scripts Canada
Core
Administer operational efficiency processes to manage costs and optimize results within the Fraud, Waste and Abuse Program through financial data analysis, reporting, and quality assurance.
Role type
Senior IC operations analyst (fraud, waste, and abuse)
Builds
Financial reports, audit recovery tracking, quality assurance metrics, forecasting tools, and training documentation for public and private sector clients.
Domain
Health benefits management / Pharmacy Benefit Management (PBM)
Deliverable
dashboards & analysis
Required skills
Financial data analysis, reporting, quality assurance, Microsoft Access, Excel, data warehousing, large data validation, process mapping, SOP creation, training delivery, stakeholder management, project management.
Preferred skills
Experience in Pharmacy/Dental Benefits Management, Group Insurance, or Health Care Operations.
Technologies
Microsoft Access, Excel, data warehousing applications
Responsibilities
Produce financial reports and insights for clients; manage provider electronic withhold entries for audit recoveries; collect and analyze quality assurance data; create and maintain forecasting tools for KPIs; lead quality-focused remedial training sessions; identify emerging trends and create client presentations; resolve escalated non-routine issues.
Seniority
Mid-Senior, hands-on IC
