Jobs in Canada

25+ jobs

Added 2 mins ago
SH
Assistant Restaurant Manager
Sparkling Hill Resort
Vernon, BC
- $50,000 to $60,000 CAD / year
- Full-time
Working closely with the Restaurant Manager, the Assistant Restaurant Manager helps lead the daily operations of PeakFine Restaurant and Barrique & Java. This includes overseeing two…
Added 2 mins ago
WH
Guest Services Manager
Westmont Hospitality Group
Winnipeg, MB
- Full-time
The Guest Services Manager is responsible for leading the daily operation of the Front Office and ensuring a welcoming, efficient and consistent guest experience. This is a hands-on…
Added 17 mins ago
RE
Junior Geologist
Rubellite Energy
Calgary, AB
- Full-time
Reporting to the Geology Manager, this role is part of the Geoscience team accountable for the technical mapping, data management, and analysis that underpins Rubellite’s heavy oil…
Added 17 mins ago
SM
Software Developer – Full Stack – Senior - RQ00799
S M Software Solutions Inc
Toronto, ON
- Internship
Collaborates with business and technical inter-divisional staff and professional services to deliver and sustain API development and integration solutions through the life cycle and reports…
Added 17 mins ago
SM
Software Developer – Full Stack – Senior - RQ00798
S M Software Solutions Inc
Toronto, ON
- Internship
Collaborates with business and technical inter-divisional staff and professional services to deliver and sustain API development and integration solutions through the life cycle and reports…
Added 17 mins ago
SM
Software Developer – Full Stack – Senior - RQ00798
S M Software Solutions Inc
Toronto, ON
- Internship
Collaborates with business and technical inter-divisional staff and professional services to deliver and sustain API development and integration solutions through the life cycle and reports…
Added 17 mins ago
SM
Software Developer – Full Stack – Senior - RQ00798
S M Software Solutions Inc
Toronto, ON
- Internship
Collaborates with business and technical inter-divisional staff and professional services to deliver and sustain API development and integration solutions through the life cycle and reports…
Added 17 mins ago
SM
Software Developer – Full Stack – Senior - RQ00799
S M Software Solutions Inc
Toronto, ON
- Internship
Collaborates with business and technical inter-divisional staff and professional services to deliver and sustain API development and integration solutions through the life cycle and reports…
Added 17 mins ago
SM
Software Developer – Full Stack – Senior - RQ00799
S M Software Solutions Inc
Toronto, ON
- Internship
Collaborates with business and technical inter-divisional staff and professional services to deliver and sustain API development and integration solutions through the life cycle and reports…
Added 17 mins ago
DB
Corporate Sales Manager
DoubleTree by Hilton West Edmonton
AB · Greater Edmonton Metropolitan Area
- Full-time
The Corporate Sales Manager is responsible for driving room revenue for both DoubleTree by Hilton West Edmonton and Home2 Suites by Hilton West Edmonton through proactive sales activity,…
Added 17 mins ago
Audio Artist III - FC
Electronic Arts
Vancouver, BC
FC Audio team is looking for an experienced Audio Artist who can immediately contribute to audio development. You will oversee the audio-specific project(s) to create/maintain a quality…
Added 17 mins ago
Audio Artist II - FC
Electronic Arts
Vancouver, BC
FC Audio team is looking for an experienced Audio Artist who can immediately contribute to audio development. You will oversee the audio-specific project(s) to create/maintain a quality…
Added 32 mins ago
Store Manager, 362 2nd Ave
Bell
Fernie, BC
Opportunity for career growth, development, and promotions
Added 47 mins ago
T
District Manager - Palm Springs / San Diego
Towne
NB · Chiasson Office, NB
- Full-time
The District Manager directly oversees a specific Towne Park district and is responsible for district performance for financial, guest satisfaction, client satisfaction and business…
Added 47 mins ago
BG
Exterior Surface & Paint Centre Intern - Placement Year
BMW Group
Goodwood, ON
- Internship
…style, having some great benefits for our employees, career development, progression and work-life…
Added 47 mins ago
BG
Regional Business Development - Placement Year
BMW Group
Goodwood, ON
- Internship
Regional Business Development - Placement Year (July 2027)
Added 47 mins ago
BG
Regional Sales Operations - Placement Year
BMW Group
Goodwood, ON
- Internship
Studying towards a bachelor's degree in Business, Economics, Accountancy, or a related field and on track to achieve at least a 2:2.
Added 47 mins ago
BG
Sales Channel Development - Placement Year
BMW Group
Goodwood, ON
- Internship
Sales Channel Development - Placement Year (July 2027)
Added 47 mins ago
BG
Ownership Services Regional Dealer Support - Placement Year
BMW Group
Goodwood, ON
- Internship
Develop and support dealer business plans, target setting, performance reviews, and quarterly action plans, sharing best practice to improve results.
Added 47 mins ago
BG
Exterior Service Planning - Placement Year
BMW Group
Goodwood, ON
- Internship
…operational tasks, attend team debriefs, and assist in delivering key business objectives. The role offers a valuable opportunity to gain hands-on experience of how major automotive…
Added 47 mins ago
BG
Global Private Office Brand Experience - Placement Year
BMW Group
Goodwood, ON
- Internship
The Private Office Sales team is dedicated to delivering an exceptional client experience while supporting business growth through relationship management, operational excellence, and…
Added 47 mins ago
V
Licensed Practical Nurse (LPN) - Adult Emergency - Repost
VitalHires
Winnipeg, MB
- Temporary
…health services and supports centralized administrative and business functions for Manitoba health organizations. Position Overview Under the general supervision of the Manager Health…
Added 47 mins ago
V
Licensed Practical Nurse (LPN) - Adult ER -Repost
VitalHires
Winnipeg, MB
- Part-time
…health services and supports centralized administrative and business functions for Manitoba health organizations. Position Overview Under the general supervision of the Manager Health…
Added 1 hour ago
J
Drug Prior Authorization Case Manager
Jobgether
Canada
- Full-time
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.
Added 1 hour ago
B
Practice Consultant
BoomerangFX
Mississauga, ON
- Full-time
…rare in its scale, recession resilient and powered by a strong business model with an impressive leadership team. Trusted by a growing community of healthcare professionals across North…

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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