Pharmacy.ca | North York, Ontario
Full-Time, Permanent | On-Site, Monday to Friday
Work Arrangement: On-Site, Monday to Friday
Department: Reimbursement & Specialty Programs
Reports To: General Manager
Direct Reports: Reimbursement Program Coordinators and Administrative Assistant
Position Overview
Pharmacy.ca is seeking an experienced Reimbursement & Logistics Manager with a strong background in specialty pharmacy, pharmaceutical reimbursement, patient support programs, or pharmaceutical operations.
This is a leadership opportunity for a healthcare professional who understands the complexities of drug reimbursement, specialty pharmaceutical programs, clinic operations, and pharmaceutical distribution. The successful candidate will oversee reimbursement operations, lead a multidisciplinary team, manage clinic and external partner relationships, and drive operational performance across assigned programs.
Working closely with senior management and internal departments, the Manager will ensure efficient program delivery, strong service standards, accurate reporting, and effective operational controls. The ideal candidate combines industry knowledge with proven people leadership, analytical capabilities, business acumen, and the ability to manage competing priorities in a dynamic healthcare environment.
Key Responsibilities
Reimbursement Operations & Team Leadership
- Lead and develop the reimbursement team, including Program Coordinators and administrative support staff.
- Oversee public and private drug reimbursement activities, including eligibility assessments, coverage requirements, Special Authorization processes, case management, and escalations.
- Monitor case volumes, outstanding requests, processing timelines, productivity, and service quality.
- Establish operational priorities, allocate resources, and ensure appropriate staffing and workload distribution.
- Develop and maintain standardized procedures, workflows, training materials, and quality controls.
- Identify operational gaps and implement improvements to enhance efficiency, accuracy, and service delivery.
Specialty Pharmacy & Patient Support Programs
- Oversee the operational delivery of assigned specialty pharmaceutical programs and patient support services.
- Ensure effective coordination of program enrollment, clinic onboarding, account administration, documentation, and ongoing program requirements.
- Maintain professional relationships with pharmaceutical partners, healthcare providers, clinics, and other external stakeholders.
- Coordinate program requirements, operational updates, reporting obligations, and service-related escalations.
- Monitor program performance and ensure deliverables are completed within established timelines and quality standards.
- Identify opportunities to strengthen program delivery, improve stakeholder experience, and support the expansion of existing services.
Clinic & Business Relationship Management
- Serve as a senior operational contact for clinic-related matters, reimbursement challenges, service escalations, and operational concerns.
- Build and maintain strong working relationships with physicians, clinic managers, nurses, and healthcare professionals.
- Proactively engage with existing clinic accounts to understand operational needs, address service gaps, and strengthen long-term relationships.
- Collaborate with internal teams to resolve concerns and maintain consistent service standards.
- Identify opportunities to expand existing accounts, develop new clinic relationships, and support business growth in collaboration with senior management.
- Monitor industry developments and emerging market needs to identify potential business opportunities and operational risks.
Pharmaceutical Logistics & Distribution
- Oversee assigned pharmaceutical distribution and logistics activities, ensuring accurate and timely order processing and delivery coordination.
- Coordinate inventory and replenishment requirements, shipment tracking, distribution records, and partner communications.
- Monitor distribution workflows and address operational discrepancies, delays, and service concerns.
- Ensure appropriate documentation, inventory coordination, and distribution controls are maintained.
- Work collaboratively with Pharmacy, Shipping, Customer Service, and external partners to support reliable end-to-end operations.
Quality Assurance, Compliance & Reporting
- Oversee operational quality reviews, file audits, data validation, and documentation requirements.
- Coordinate external partner audit requirements, pharmacovigilance documentation, and applicable program reporting activities.
- Monitor key performance indicators, including case volumes, turnaround times, productivity, error rates, and service quality.
- Prepare and review operational reports, identify trends, and provide meaningful performance insights to senior management.
- Investigate discrepancies, document findings, and oversee corrective and preventive actions.
- Maintain confidentiality of patient, clinic, and business information in accordance with applicable privacy, security, and regulatory requirements.
- Escalate significant operational, compliance, and quality concerns to the appropriate leadership or designated professionals.
Systems, Financial Coordination & Continuous Improvement
- Oversee operational systems and reporting processes supporting reimbursement, pharmacy, specialty programs, and distribution activities.
- Coordinate data extraction, validation, reconciliation, and reporting across relevant business systems.
- Utilize reporting and analytical tools to monitor performance, identify trends, and support operational decision-making.
- Collaborate with Accounting on operational reconciliations, billing discrepancies, purchase orders, accounts receivable reporting, and related financial processes.
- Work cross-functionally with Pharmacy, Accounting, Customer Service, Shipping, IT, and Business Development to resolve operational challenges.
- Identify opportunities to streamline processes, strengthen internal controls, improve data integrity, and enhance overall operational efficiency.
Qualifications & Experience
- Post-secondary education in Healthcare Administration, Business Administration, Pharmaceutical Sciences, Health Sciences, or a related discipline; an equivalent combination of education and relevant experience will be considered.
- Minimum 5 years of relevant experience in specialty pharmacy, pharmaceutical reimbursement, patient support programs, pharmaceutical operations, or healthcare program management.
- Demonstrated experience leading teams, managing operational workflows, and overseeing service delivery.
- Strong understanding of public and private drug reimbursement processes, Special Authorization requirements, and specialty pharmaceutical program operations.
- Experience working with pharmaceutical manufacturers, specialty drug suppliers, healthcare providers, clinics, or other industry partners.
- Experience overseeing pharmaceutical distribution, logistics, inventory coordination, or related operational activities.
- Demonstrated experience with quality assurance, operational audits, performance reporting, and data analysis.
- Advanced proficiency in Microsoft Excel and Microsoft Office applications.
- Experience working with pharmacy management systems, reimbursement platforms, databases, and business reporting tools is an asset.
- Experience with SQL, Power BI, Microsoft Access, or similar analytical tools is considered an asset.
Core Competencies
- Strategic & Operational Leadership: Ability to translate business objectives into operational priorities and lead teams toward measurable results.
- Industry Expertise: Strong understanding of specialty pharmacy, reimbursement operations, pharmaceutical programs, and healthcare service delivery.
- People Management: Ability to coach, develop, motivate, and hold employees accountable while building a collaborative team environment.
- Business Development: Commercial awareness and the ability to recognize opportunities for account growth, service expansion, and stronger business relationships.
- Relationship Management: Strong communication and stakeholder management skills, with the ability to work effectively with healthcare professionals and external partners.
- Analytical Thinking: Ability to interpret operational data, identify performance trends, investigate discrepancies, and make informed recommendations.
- Problem-Solving & Decision-Making: Strong judgment and the ability to manage escalations, competing priorities, and time-sensitive operational challenges.
- Accountability & Execution: Highly organized, detail-oriented, and capable of delivering results in a fast-paced healthcare environment.
Performance Expectations
The successful candidate will be expected to demonstrate measurable results in:
- Reimbursement accuracy, processing efficiency, and service turnaround times.
- Team performance, employee development, and operational accountability.
- Specialty program delivery and external partner satisfaction.
- Clinic relationship development, retention, and account growth.
- Pharmaceutical distribution accuracy and operational reliability.
- Audit readiness, documentation, quality assurance, and compliance.
- Reporting accuracy, data integrity, and continuous process improvement.
Benefits
- Health Care Spending Account (HCSA)
- Paid time off
- On-site parking
- Employee store discount
- Company events
