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Jobs in Canada

25+ jobs

Added 10 mins ago
M
Bilingual Client Success Manager
Maple
Toronto, ON
- Full-time
Flex benefits: An annual budget built for your growth and well-being. Use it for professional development, wellness expenses or a one-time boost to your retirement savings. You choose what…
Added 10 mins ago
C(
Payroll Specialist
CenterLine (Windsor) Limited
Lasalle, ON
- $26 to $36 CAD / hour
- Full-time
…is responsible for the accurate and timely administration of full-cycle payroll for hourly and salaried employees, ensuring compliance with federal and provincial legislation, company…
Added 23 mins ago
SN
Director of Development
Science North & Dynamic Earth
Sudbury, ON
- Full-time
…building relationships and a proven ability to grow philanthropic support that advances organizational priorities. This is an opportunity to strengthen the resources that sustain…
Added 23 mins ago
FN
Executive Assistant
First Nations Engineering Services Ltd.
Ohsweken, ON
- $50,000 to $100,000 CAD / year
- Full-time
The Executive Assistant is responsible for providing direct administrative and executive support to both the President and General Manager. This position requires a highly organized,…
Added 23 mins ago
GO
Grant Advisor
Government of Alberta
AB · Edmonton, AB
- Full-time
As a Grant Advisor, you will support the implementation, administration, and continuous improvement of capital grant programs throughout the full grant lifecycle. You will provide expert…
Added 23 mins ago
M
Retail Business Development Representative
Middlebox
Vancouver, BC
- Full-time
This position starts as a month-to-month contract with a path to full-time. It's remote to start, with a move to a hybrid schedule (roughly 3 days a week from a Vancouver coworking space)…
Added 25 mins ago
SL
Engineering Manager
Sun Life
Toronto, ON · Waterloo, ON · Sun Life Waterloo King
- Full-time
When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in…
Added 25 mins ago
7
Delivery Assistant Manager (Nights)
7-Eleven
AB · SEDCC Edmonton Warehouse
- Full-time
…productivity across delivery functions, ensuring workload balance, on‑time departures, complete documentation, and a safe, organized workspace. This position promotes strong teammate…
Added 25 mins ago
CT
Office Coordinator
Creation Technologies
Vancouver, BC
- Full-time
…for new hires for this position is between $20-$23 per hour. Full-time employees are also eligible for performance based bonuses and benefits. This is not a guarantee of compensation or…
Added 25 mins ago
C
Sr. Manager, Production Application Support
CIBC
Toronto, ON
- Full-time
…your role. To successfully perform the work, you’ll be on-site full-time. You’ll have the flexibility to manage your work activities within a hybrid work arrangement where you’ll spend 1-3…
Added 25 mins ago
TT
Retail Store Associate Full Time Winners - Warden Woods
The TJX Companies, Inc.
Toronto, ON
- Full-time
Support for you and your family through our Associate and Family Assistance programs, offering helpful resources and services to enhance your well-being.
Added 41 mins ago
OD
Account Executive, Business Sales - Vaughan
OSL Direct Services
Vaughan, ON · Newmarket, ON
- Other
Full-time availability of 37.5 hours per week
Added 41 mins ago
OD
Account Consultant (Sales & Marketing) + Signing Bonus - North York
OSL Direct Services
Toronto, ON · North York, ON
- Other
…who are ready for their next big career move. OSL people are professional, willing to adapt and learn new skills, and are social by nature. Our people are what make OSL an award-winning,…
Added 41 mins ago
Receptionist
Bayshore
Edmonton, AB
Full-Time | Monday to Friday, 8:00 AM-4:00 PM
Added 41 mins ago
FF
Principal Software Engineer
Forward Financing
Remote, Canada
- $200,000 to $250,000 CAD / year
- Full-time
- Remote
…empower small businesses. Our engineering team isn't just a support function, we're a core driver of the business. We use data from dozens of third-party vendors to fuel our AI/ML…
Added 41 mins ago
UH
Administrative Quality Lead
University Health Network
Toronto, ON
- Full-time
Support current administrative staff and other team member practices within the department and utilize Standard Operating Procedures, Policies and Patient Centered Care to validate or…
Added 41 mins ago
R
Pricing Manager
REXEL
Vancouver, BC
- $90,000 CAD / year
- Full-time
Analyze pricing trends, competitive positioning, and profitability metrics to support decision-making.
Added 41 mins ago
R
Pricing Manager
REXEL
Toronto, ON
- $90,000 CAD / year
- Full-time
Analyze pricing trends, competitive positioning, and profitability metrics to support decision-making.
Added 55 mins ago
R
Senior Manager, Treasury Solutions, Capital Markets
RBC
Toronto, ON
- Full-time
Provide support for operational/transactional risk working appropriately with Capital Market partners/Business Risk/Client Service (includes Client Service , account documentation, etc.)
Added 55 mins ago
DS
Manager of Procurement and Risk Management Services
District School Board of Niagara
ON · Ontario, Canada
- Full-time
…and enrolment in the OMERS pension plan. This is a permanent full-time, 12-month, 35 hour per week position and is part of the Board's union-exempt Administrative Management…
Added 55 mins ago
D
Senior Consultant/Manager - Treasury Transformation
Deloitte
Toronto, ON
- Full-time
…future. And as the largest 100% Canadian-owned and operated professional services firm in our country, we are proud to work alongside our clients to make a positive impact for all…
Added 55 mins ago
KP
Director, Student Access and Disability Resources - Competition ID: 4664
Kwantlen Polytechnic University
Surrey, BC
- Full-time
Demonstrated business acumen, strong work ethic, and professional integrity when representing the university.
Added 55 mins ago
GR
Executive Assistant to the Director
Goldbeck Recruiting
Vancouver, BC
- $60,000 to $65,000 CAD / year
- Full-time
…facility. This is an opportunity for a hardworking and committed professional who takes pride in providing exceptional support and is willing to go above and beyond to help the Director and…
Added 55 mins ago
UO
Administrator, Competition Development
University of Manitoba
Winnipeg, MB
- Full-time
Under the direction of the Administrator, Competition Events, the incumbent will support the growth and day-to-day administration of the Asper School of Business’ Case Competition…
Added 55 mins ago
ME
Director of Business Development
Morson Edge (Canada)
Ottawa, ON
- Full-time
Lead the full business development lifecycle, including opportunity identification, qualification, positioning, capture planning, proposal strategy, pricing strategy, contract award, and…

Drug Prior Authorization Case Manager

Canada

Competitive salary range of $43,875–$73,125 CAD, depending on location, qualifications, experience, and other job-related factors. · Full-time

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Job details

Pay: Competitive salary range of $43,875–$73,125 CAD, depending on location, qualifications, experience, and other job-related factors.
Job type: Full-time
Experience: 2–3 years of experience in a customer-focused environment, case management, claims, or a related field.
Posting language: English
Posted: Oct 5, 2026

Original job description

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Drug Prior Authorization Case Manager based in Canada.

This role is responsible for the end-to-end management of complex drug prior authorization and claims cases. You will independently assess requests against clinical guidelines, plan provisions, and approval criteria while ensuring accurate and timely decisions. The position involves direct communication with members, providers, pharmacies, and internal stakeholders. You will handle sensitive, escalated, high-value, and non-standard cases that require research, sound judgment, and detailed analysis. As a subject matter expert, you will also support internal teams, outsource partners, training, and knowledge-sharing initiatives. The role combines customer service, claims expertise, risk management, and continuous improvement within a collaborative and evolving environment.

\nAccountabilities:

Manage the intake, review, and adjudication of drug prior authorization requests, evaluating submissions against clinical guidelines, plan provisions, and established approval criteria.
Take full ownership of assigned cases from initial intake through resolution, prioritizing work according to urgency, complexity, customer impact, and service-level requirements.
Communicate authorization and claim outcomes clearly and professionally to members, healthcare providers, pharmacies, and internal stakeholders while maintaining expected turnaround times.
Investigate and resolve complex, escalated, sensitive, high-value, and non-standard claims or authorization scenarios through detailed research, analysis, and sound judgment.
Serve as a subject matter expert in prior authorization and claims adjudication, providing guidance to internal teams and external or outsourced partners.
Apply risk-management principles when assessing requests and contribute to effective resolution of escalated claims issues.
Participate in initiatives focused on operational efficiency, quality, customer experience, knowledge sharing, training, and continuous improvement.
Support broader organizational objectives related to financial efficiency, customer satisfaction, operational performance, and strategic priorities.

Requirements

Post-secondary education or an equivalent combination of education and relevant professional experience.
2–3 years of experience in a customer-focused environment, case management, claims, or a related field.
Previous experience in group benefits, claims management, disability management, insurance, or another regulated environment is required.
Proficiency with Microsoft Office 365 and confidence working with digital tools and systems in a professional environment.
Knowledge of benefits administration, medical and dental terminology, or claims-related practices is an asset.
Excellent written and verbal communication skills, with the ability to interact effectively with a diverse range of internal and external stakeholders.
Strong analytical, problem-solving, decision-making, and investigative skills, with the ability to assess risk and resolve challenging situations.
Strong attention to detail, sound judgment, confidentiality, and a customer-focused approach are essential.
Ability to manage multiple priorities in a fast-paced and changing environment while working independently and collaborating effectively with a team.
Strong influencing, negotiation, collaboration, and relationship-building skills, combined with adaptability and a willingness to embrace new technologies.
A continuous improvement mindset, solution-oriented approach, and experience acting as a subject matter expert, mentor, or informal leader are considered valuable.

Benefits

Competitive salary range of $43,875–$73,125 CAD, depending on location, qualifications, experience, and other job-related factors.
Opportunity to participate in incentive programs with compensation linked to individual and business performance.
Hybrid working arrangement with WorkSmart flexibility available.
Comprehensive health and dental coverage, including mental health and vision benefits.
Short- and long-term disability, life, and AD&D insurance coverage.
Adoption, surrogacy, wellness, and employee/family assistance benefits.
Retirement savings options, including pension and a global share ownership plan with employer matching contributions.
Access to financial education and counseling resources.
Generous paid time off, including holidays, vacation, personal and sick days, plus applicable statutory leaves.
Flexible and inclusive working environment focused on employee well-being, professional development, and career growth.
Opportunity to contribute to a global organization while developing expertise in complex claims and prior authorization management.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Why Apply Through Jobgether?

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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More about this job

Responsibilities

Manage the end-to-end adjudication of drug prior authorization requests by evaluating submissions against clinical guidelines and plan provisions. Investigate and resolve complex, escalated, or non-standard claims while serving as a subject matter expert for internal and external stakeholders.

Requirements

Requires post-secondary education and 2–3 years of experience in case management, claims, or group benefits. Candidates must possess strong analytical skills, proficiency with Microsoft Office 365, and the ability to work independently in a fast-paced environment.

Skills

Case management
Claims adjudication
Risk management
Clinical guidelines assessment
Medical terminology
Dental terminology
Analytical skills
Problem-solving
Decision-making
Communication
Negotiation
Relationship building
Microsoft Office 365
Benefits administration
Investigative skills
Customer service

Benefits

Health insurance
Dental coverage
Mental health benefits
Vision benefits
Short-term disability insurance
Long-term disability insurance
Life insurance
AD&D insurance
Adoption benefits
Surrogacy benefits
Wellness programs
Employee assistance program
Retirement savings plan
Pension plan
Share ownership plan
Paid time off

Visa sponsorship

Not detected in the job text

Keywords

Drug Prior Authorization
Case Management
Claims Adjudication
Group Benefits
Risk Management
Clinical Guidelines
Medical Terminology
Dental Terminology
Microsoft Office 365
Insurance
Disability Management
Customer Service
Analytical Skills
Problem-solving
Decision-making
Negotiation
Relationship Building
Operational Efficiency
Quality Assurance
Continuous Improvement
Subject Matter Expert
Hybrid Work
WorkSmart
Financial Efficiency
Stakeholder Management

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