Provider Relations Operations Manager - Express Scripts Canada

Cigna

  • Mississauga, ON
  • Permanent
  • Temps-plein
  • Il y a 16 jours
The Provider Relations Operations Manager at Express Scripts Canada (ESC) is responsible for leading a team of individuals who work with healthcare providers, including pharmacies, dental providers, and extended health care provider. The Provider Relations Operations Manager is responsible for the day-to-day leadership of the team providing direction and is accountable for managing performance, workflow management, departmental priorities, and client service delivery, ensuring alignment with corporate and departmental objectives. The Manager will develop and implement strategies to optimize provider management services, participate in communication items with healthcare providers and stakeholders, and support the overall goals of the Provider Relations team. Additionally, the Manager will provide tactical plans for executing resource deployment strategies, a balanced and level workflow, and output expectations based upon demand and capacity analysis on a daily, weekly, and monthly basis.Office Location: Mississauga, ONWorking Environment: Hybrid, 2 days/week on-siteKey Responsibilities:
  • Lead and develop the Provider Relations team, including direct and indirect reports, by establishing clear goals and objectives, ensuring accountability, managing and leading change
  • Provide day-to-day leadership for effective oversight of service delivery and operational excellence to achieve strategic goals and maximize best outcomes.
  • Develop, monitor, and assess key performance indicators to support data-driven decisions in mitigating risk and exploring opportunities to streamline, automate, and improve existing services.
  • Design and support the creation and maintenance of forecasting and trending tools for oversight on key performance indicators, service delivery, turn around times, quality assurance, resource planning, and emerging trends.
  • Conduct sustainability assessments by tracking and measuring business results and foster a culture of continuous improvement and sustainability.
  • Foster a people-first culture that develops team members' skills and capabilities to enable personal and business growth.
  • Handle escalations for high-priority items to ensure departmental deliverables are met.
  • Manage PR initiatives/projects/enhancements ensuring they are delivered on time and within quality and acceptance criteria targets.
  • Support communications related initiatives to ensure quality communication with healthcare providers, associations, provincial colleges, pharmacy chains, software vendors, third-party suppliers, and internal and external clients.
  • Participate in and help build professional relationships with healthcare providers and associations to provide support, resolve issues, and provide ongoing education on ESC policies.
  • Ensure that team members are effectively trained and provided with the appropriate tools, including evergreen process documentation, to achieve success in their roles.
  • Work cross-functionally with ESC teams to enable the best holistic outcomes for the organization.
  • Partner with applicable business leaders and legal to ensure provider contracts and manuals align with ESC strategy and client business needs.
  • Participate in client meetings and develop strategies to ensure/increase client satisfaction.
  • Support ad hoc projects, including requests for proposals as required.
  • Conduct resource planning quantitative analysis, predictive modeling, and forecasting.
  • Create and distribute resource requirements and oversee the schedules adjustments to meet cost and service level goals.
  • Provide retrospective analysis of schedule performance based on real-time results and historical trends.
  • Oversee the time-off planning, manage budget allotment, and monitor extra hours and overtime.
  • Analyze volume trends to predict staffing needs and ensure efficient resource allocation.
  • Provide reports on trends, productivity, quality, and service levels.
  • Assist in developing department procedures.
  • Responsible for coordinating system testing with software vendors to ensure compliance with correct adjudication methods and UATs.
Qualifications:
  • Bachelor’s degree or equivalent work experience.
  • Minimum of 5 years operational experience with demonstrated people leadership capabilities and business outcomes.
  • Minimum of 3-5 years’ experience in a supervisory/leadership role.
  • Experience in Group Benefits and/or Pharmacy Benefit Management.
  • Ability to demonstrate leadership through effective mentoring and coaching of others to achieve results and build/maintain a high-performance culture.
  • Excels at fostering cross-functional teamwork and partnerships.
  • Self-starter able to work in a dynamic, fast-paced environment and make independent decisions.
  • Proven skills in time management, planning, prioritization, resiliency, and employee performance management.
  • Strong client service focus through adaptability, flexibility, and a commitment to quality.
  • Excellent verbal and written communication skills.
  • Change management skills and experience.
  • Highly proficient in MS Office (knowledge of Excel, Word, and PowerPoint required).
  • Limited travel will be required.
  • Bilingualism (English and French) considered an asset.
NOTE: Internal candidates should apply before August 26, 2025.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 environment. 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. 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.If you require accommodation in completing the online application process, please email: Do not email for an update on your application or to provide your resume as you will not receive a response.

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