Job Title: Reimbursement Specialist
Location: Mississauga
Employment Type: Permanent
Reason for Vacancy: New
Work Arrangement: Hybrid
Department Name: Advocate Services
Pay Typed: Salary
Pay Range: $52,000 - $65,000
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 Us
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. 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 Reimbursement Specialist assumes responsibility for managing reimbursement related issues for patients requiring specialty medications. This role will act as the patient advocate and work closely with patients to navigate and secure potential sources of reimbursement. Together with the pharmacy services, this role will bring more convenience, lower spend, and better health outcomes to patients.
Key Responsibilities
Determine operational processes, and lead internal and external teams in implementation of program launch and ongoing utilization through assigned and self-initiated “pull through” efforts.
Drive continual process improvements to enhance work efficiencies and optimize member experience. Provide training to internal team members as required.
Manage case-by-case reimbursement for patients requiring specialty medications. Gather all pertinent information, coordinate patient cases, manage applications and work directly with the private, public, or manufacturer-sponsored drug funding programs to optimize reimbursement.
Communicate and educate patients regarding their private drug coverage and options, including status of Prior Authorization requests.
Identify and resolve reimbursement issues to facilitate pharmacy processes including prescription processing and invoicing.
Identify gaps and opportunities for clinical education and healthcare support, and liaise with the appropriate internal teams or external organizations to provide and enhance patient care.
Maintain and manage standard operating procedures and specialty medication funding program database.
Develop and maintain relationships with private/public payers, manufacturers and plan sponsors. Apply knowledge and insights to enhance Specialty Pharmacy service offerings.
Qualifications:
Bachelor’s Degree preferred
3-5 years of experience in the pharmacy benefit management, insurance, pharmacy, biotechnology, or pharmaceutical industries; customer service and/or reimbursement.
Demonstrated commitment to improve patient care
Able to work independently and within a team
Excellent written/verbal communication to include providing clear instructions
Ability to multitask
Strong problem-solving skills with the ability to resolve issues effectively and efficiently
Knowledge of the private or public drug reimbursement would be an asset
Knowledge of pharmacy dispensing software is preferred
Computer proficiency in MS Office applications, with database experience a plus
Why Join Us
Competitive compensation, benefits and pension plan
Career development and advancement opportunities
A culture that celebrates innovation and collaboration
Flexible work options and wellness programs
Pre-Employment Requirements
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 bona fide occupational requirement. 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.
Internal Application Deadline: April 2, 2026
Express Scripts Canada is a Cigna company
Express 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 Canada
Express 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: [email protected] Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
