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Jobs in Canada

25+ jobs

Added 1 min ago
R
Senior IT Advisor, audit and cybersecurity
Richter
Montreal, QC
- Full-time
Contribute to reviewing client documents (policies, procedures, technical reports, configurations) and support the development of tailored improvement proposals.
Added 1 min ago
R
Manager, Performance Marketing
Relay
Remote, Canada
- Full-time
- Remote
Relay is a digital banking platform that gives self-made business owners the tools and know-how to be great with money - bringing clarity, confidence, and control to every dollar earned, so…
Added 16 mins ago
LA
Communications and Digital Media Assistant
Legislative Assembly of Alberta
AB · Edmonton, AB
- $49,879.96 to $63,113.7 CAD / year
- Full-time
Reporting to the Manager and Supervisor of Communications Services, the Communications and Digital Media Assistant is new to the field, is an adaptive learner and is eager to support our…
Added 16 mins ago
Q(
Health & Safety Specialist
QEOSH (HSE) Staffing & Recruitment Inc.
Winnipeg, MB
- Full-time
Reports: The Health & Safety Specialist will report to the President and Operations Manager.
Added 32 mins ago
L
Senior Data Analyst
Legend
Halifax, NS
- Full-time
Experience within sports betting, iGaming or another digital business with strong web analytics exposure is highly desirable.
Added 32 mins ago
EB
Bilingual Residential Mortgage Underwriter
EQ Bank | Canada's Challenger Bank
Montreal, QC
- Full-time
…enrich people's lives. Our customers have named our EQ Bank digital platform (eqbank.ca) one of the top banks in Canada on the Forbes World's Best Banks list since…
Added 32 mins ago
Program Manager
The Aldo Group Inc / Le Groupe Aldo Inc.
Montreal, QC
The Program Manager, Digital Growth & Enablement is an experienced and highly organized delivery leader within our Centre of Excellence (CoE). This role is responsible for driving the…
Added 32 mins ago
CF
Business Account Manager
Canadian Fiber Optics Corp
Edmonton, AB
- Full-time
As an Account Manager, you will own business development within an assigned Alberta territory. Your primary focus will be acquiring new customers while also identifying opportunities to…
Added 32 mins ago
Mortgage Solutions Manager - Tangerine
Scotiabank
Toronto, ON
At Tangerine, we’re redefining banking. As Canada’s leading digital bank, we thrive on innovation, agility, and bold thinking, tackling every challenge head-on with leading technology and…
Added 32 mins ago
T
Personal Banking Associate
TD
Brampton, ON
- Full-time
…opportunities to all colleagues. Growth opportunities and skill development are defining features of the colleague experience at TD. Our compensation policies and practices have been…
Added 32 mins ago
J&
Senior Finance Manager, Surgery Canada
Johnson & Johnson Innovative Medicine
Markham, ON
- Full-time
We are searching for the best talent for a Senior Finance Manager, Surgery Canada to be in Markham, ON.
Added 46 mins ago
Senior Manager, Social & Integrated Campaigns
Later
Vancouver, BC
We’re looking for a Senior Manager, Social & Integrated Campaigns to develop and bring to life differentiated, platform-native campaigns across organic social, influencer, and CTV.
Added 46 mins ago
Train Performance Manager
Alstom
Saint-Bruno, QC
…to turnkey systems, services, infrastructure, signalling and digital mobility, we offer our diverse customers the broadest portfolio in the industry. Every day, more than 80 000 colleagues…
Added 46 mins ago
Software Quality Metier Manager
Alstom
Saint-Bruno, QC
…to turnkey systems, services, infrastructure, signalling and digital mobility, we offer our diverse customers the broadest portfolio in the industry. Every day, more than 80 000 colleagues…
Added 1 hour ago
OP
Associate Director, Talent Acquisition
Omnicom Precision Marketing
Calgary, AB
- Full-time
Champion Employer Branding – Build Critical Mass's reputation as an employer of choice in the digital agency space
Added 1 hour ago
OP
Associate Director, Talent Acquisition
Omnicom Precision Marketing
Toronto, ON
- Full-time
Champion Employer Branding – Build Critical Mass's reputation as an employer of choice in the digital agency space
Added 1 hour ago
HH
PRO Marketing Specialist
Home Hardware Stores Limited
St. Jacobs, ON
- Full-time
…Home’s overall PRO Marketing efforts. Led by the PRO Marketing Manager, this opportunity will best suit someone who has strong marketing, organizational and communication…
Added 1 hour ago
H
Technical Delivery Lead
Hays
Toronto, ON
- $120 to $135 CAD / hour
- Contract
Our client in the financial services sector is seeking a Technology Delivery Lead to join their Digital Banking and Channel Technology team. This is a leadership role focused on driving the…
Added 1 hour ago
TP
Senior Representative, Passenger Care (Term Opportunity - One Year)
Toronto Pearson International Airport
Toronto, ON
- Temporary
Reporting to the Manager, Passenger Care, this role leads the development, implementation, and continuous improvement of accessibility and passenger care programs across Toronto Pearson…
Added 1 hour ago
SF
Loss Prevention Analyst
Soul Foods Group
ON · Ontario, Canada
- $68,000 to $75,000 CAD / year
- Full-time
…include but are not limited to spot checks, high resolution digital CCTV and advanced interviewing…
Added 1 hour ago
TI
Digital Project Manager
Treefrog Inc.
Canada
- Full-time
Treefrog is seeking a Digital Project Manager to join our team on a full-time basis to fill an existing role. This role sits at the centre of our delivery operations, ensuring client…
Added 1 hour ago
F
Manager, Marketing Operations & AI
Flywheel
Toronto, ON
- Full-time
Flywheel's suite of digital commerce solutions accelerate growth across all major digital marketplaces for the world's leading brands. We give clients access to near real-time performance…
Added 1 hour ago
F
Commerce Specialist
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Toronto, ON
- Full-time
…ensure a well-rounded Commerce individual to enable career development and acceleration. This role is an excellent opportunity for the analytically minded individual who’s curious, a…
Added 1 hour ago
F
R2026-199 Business Development Representative
Flywheel
Toronto, ON
- Full-time
Flywheel’s suite of digital commerce solutions accelerates growth across all major digital marketplaces for the world’s leading brands. We give clients access to near real-time performance…
Added 1 hour ago
F
Senior Commerce Specialist
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- Full-time
Flywheel’s suite of digital commerce solutions accelerates growth across all major digital marketplaces for the world’s leading brands. We give clients access to near real-time performance…

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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