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Jobs in Canada

25+ jobs

Added 11 mins ago
SC
assistant manager, restaurant
Second Cup
Ottawa, ON
- Full-time
Added 11 mins ago
QH
Manager, Pharmacy Operations
Quinte Health
Belleville, ON
- Full-time
Reporting to the Director of Pharmacy, the Manager, Pharmacy Operations provides operational leadership and oversight of the day-to-day delivery of Pharmacy Services across Quinte Health.
Added 11 mins ago
PV
assistant manager - retail
Pet Valu
Devon, AB
- Full-time
Added 11 mins ago
TS
Protection Services Worker
The Salvation Army in Canada
Fort McMurray, AB
- Full-time
Assist Facilities Manager/Maintenance Assistant with duties in all salvation army properties, when required.
Added 11 mins ago
BC
Registered Nurse - Medical B7
Brant Community Healthcare System
Brantford, ON
- Full-time
Reporting to the Clinical Manager, Medically Integrated Program, the successful applicant will be responsible for providing evidence based, comprehensive, safe, effective and ethical…
Added 11 mins ago
LC
Merchandiser, Hourly Part Time Day
Loblaw Companies Limited
Osoyoos, BC
- Part-time
Supports Front Store Manager/Assistant Front Store Manager in maintaining the quality and standards
Added 11 mins ago
AI
Human Resources Business Partner
ATS Industrial Automation
Woodbridge, ON
- Full-time
With support of their manager, recommend, develop, and administer human resources policies, procedures, and programs in support of business initiatives ensuring compliance with governing…
Added 11 mins ago
LC
Associate Product Manager, President's Choice & no name
Loblaw Companies Limited
Brampton, ON
- Full-time
Associate Product Manager, President’s Choice & no name
Added 11 mins ago
HR
Quality Assurance Intern (Winter 2027, 12months)
Hitachi Rail
Toronto, ON
- $23 to $30 CAD / hour
- Full-time
Assist Quality Assurance Manager in follow up on various tasks:
Added 11 mins ago
DG
Sales Consultant
Dilawri Group of Companies
Langley (District), BC · Langley, BC
- Full-time
Acura of Langley is seeking a Sales Consultant to join our dynamic sales team. Reporting to the Sales Manager, this role plays a key part in driving dealership growth by cultivating…
Added 11 mins ago
JF
Development & Community Engagement Coordinator
Jewish Federation of British Columbia (JFBC)
BC · West Vancouver, BC
- Full-time
This role reports to the Executive Director and works alongside the Manager, Executive Administration and Operations for shared front-desk coverage, and alongside the Program Development &…
Added 11 mins ago
ML
Drug and Alcohol Peer Worker
Murrumbidgee Local Health District (MLHD)
Griffith, ON
- Full-time
Added 11 mins ago
M
department store manager
MAXI
Amos, QC
- Full-time
Added 11 mins ago
PH
Customer Care Coordinator
ParaMed Home Health Care
Kitchener, ON
- Part-time
Under the direction of the Operations Manager and reporting to the Supervisors of Coordination, the Customer Care Representative will act as the primary point of contact for clients and…
Added 11 mins ago
B
Tenant Services Coordinator
BGIS
Toronto, ON
- Full-time
…drive innovation for our clients’ businesses. Globally, we manager over 320 million square feet of client portfolios across 30,000+ locations in North America, Europe, Middle East,…
Added 11 mins ago
B
Digital Operations Manager (18 months contract)
Bell
Toronto, ON
- Full-time
The Digital Operations Manager plays a key role in advancing Bell Media’s digital advertising products. In this role, you will act as a subject matter expert in advertising innovation and…
Added 11 mins ago
CM
Sport & Exercise Medicine Physician
Changepain Medical & Allied Health Clinic
Burnaby, BC
- Contract
Version / review cycle: v1.0 - reviewed annually by Medical Director & Operations Manager
Added 11 mins ago
MG
Human Resources Analyst
Michael Garron Hospital
Toronto, ON
- Full-time
Reporting to the Manager, Human Resources and as part of the HRIS implementation project team, the
Added 11 mins ago
OC
Student, Farm Worker
Olds College of Agriculture & Technology
Olds, AB
- $15.45 to $16.48 CAD / hour
- Full-time
…supporting additional activities under the guidance of the Assistant Manager, the Farm Service Worker will ensure that his/her duties are performed in a safe, effective and efficient…
Added 11 mins ago
YP
Leasing Coordinator
York Property Management
London, ON
- $45,000 CAD / year
- Full-time
Added 11 mins ago
A
Senior Incident and Problem Manager
Aviso
Toronto, ON
- $115,000 to $125,000 CAD / year
- Full-time
We're looking to fill an opening for a Senior Incident and Problem Manager to join our Technology Ops & Support Partners team.
Added 11 mins ago
US
Service Technicians
University Sprinkler Systems Inc
Delta, BC
- Full-time
Added 11 mins ago
EV
restaurant manager
East Village Pub & Eatery
Fort McMurray, AB
- Full-time
Added 11 mins ago
N
Regional Sales Manager - Central Region
Nexans
Markham, ON
- Full-time
As a Regional Sales Manager Central Region, you will report directly to the National Sales Director, Connect.
Added 11 mins ago
CA
Sports Medicine Physician for The Institute of Human Mechanics in Toronto, ON
Canadian Academy of Sport & Exercise Medicine
Toronto, ON
- Full-time

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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