National Health Claim jobs

Saskatchewan Blue Cross®, one of Saskatchewan’s Top Employers, is currently recruiting for a full-time permanent Drug Benefits Strategist to join our team in the Health & Dental Claims and Corporate Services department. This position offers the flexibility to be in-office or participate in hybrid options in our Saskatoon or Regina office.

JOB FUNCTION

Reporting to the Manager, Health & Dental Claims and Corporate Services, the Drug Benefits Strategist plays a pivotal role in shaping sustainable drug benefit solutions that support member access to medications while managing overall drug plan costs. This position leads key pharmacy benefit management initiatives and develops strategies that enhance plan performance, sustainability, and value.

The Drug Benefits Strategist brings expertise on the evolving pharmaceutical landscape, builds strong relationships with industry stakeholders, and leverages business intelligence to identify emerging trends and opportunities. Through strategic insight and innovation, this role helps drive the development of new products, services, and reimbursement approaches that support effective benefit management and exceptional member outcomes.

WHY CHOOSE SASKATCHEWAN BLUE CROSS?

We’re driven by a mission to empower communities on their journey to whole health and wellness, and have a lot of exciting things ahead of us. We’re improving our members’ experiences through investment in our people, technology, services and products. When you join our team, you’re joining an organization where employees are valued, recognized for their contributions and empowered to make us stronger. The wellbeing of our employees, our members, our partners and our communities is at the heart of our operations.

Our industry is evolving fast, and so are we! We’re looking for people who:

• Share our values
• Believe that creating great experiences is totally within their control
• Collaborate and always set others up for success
• Build positive relationships and an understanding of what people’s needs are
• See solutions and possibilities (not problems!)
• Are simply outstanding at what they do

DUTIES & RESPONSIBILITIES

• Develop and execute pharmacy benefit management practices, including the maintenance, enhancement, and auditing of drug benefit lists and formularies
• Evaluate clinical and economic evidence to support drug listing decisions for new and existing therapies
• Analyze drug claims data, utilization patterns, and market trends to identify opportunities for plan innovation, cost management, and improved member outcomes
• Develop and share reporting, insights, and recommendations with internal stakeholders, industry partners, and decision-makers
• Support the development of formularies, prior authorization criteria, reimbursement strategies, and other plan design controls that balance effective coverage with cost sustainability
• Research and recommend enhancements to systems, processes, and controls that improve member experience, medication adherence, and public plan integration
• Monitor pharmaceutical, regulatory, and competitor trends to ensure benefit programs remain competitive, compliant, and aligned with industry best practices
• Build and maintain strong relationships with pharmaceutical manufacturers, pharmacy partners, healthcare professionals, and other key stakeholders to support strategic benefit initiatives
• Participate in cross-functional projects, committees, and organizational initiatives while providing expertise on complex drug benefit inquiries, escalated claims, and appeals
• Champion change initiatives and ensure effective communication with internal and external stakeholders impacted by drug benefit programs and processes
• Ensure compliance with organizational policies, confidentiality requirements, and industry regulations while contributing to ongoing business priorities and initiatives
• Perform various other projects on an as-requested basis and other related duties as assigned

QUALIFICATIONS & SKILLS

• Completion of a Pharmacy Assistant Certificate or Pharmacy Technician Diploma, combined with experience working in a pharmacy setting is required
• Experience working in the insurance industry, and completion of certificates in FLMI, CEBS, or ICA, would be considered an asset
• Strong analytical, problem-solving, and decision-making skills, with the ability to interpret complex information and make sound recommendations
• Excellent organizational skills, strong attention to detail, and a commitment to continuous learning and professional development
• Proven ability to manage competing priorities, adapt to changing workloads, and meet deadlines in a fast-paced environment
• Strong computer skills, including proficiency with Microsoft 365 applications such as Excel and Word, and the ability to quickly learn new systems and technologies
• Excellent written, verbal, and interpersonal communication skills, with the ability to build relationships and communicate effectively with a variety of stakeholders
• A collaborative approach and the ability to work independently while contributing to team and organizational goals
• Must be legally entitled to work in Canada on an unrestricted basis
• The successful candidate will be required to complete a Criminal Record Check and background check satisfactory to Saskatchewan Blue Cross

#SBCCareers

Saskatchewan Blue Cross is an equal opportunity employer committed to diversity and inclusion and considers all qualified applicants for employment without regard to race, color, religion, age, sex, sexual orientation, gender, gender identity, national origin, disability, veteran status, or any other legally protected characteristic.

We are also deeply committed to Indigenous inclusion. We recognize the importance of lived experience, cultural knowledge, and traditional leadership. These are valued alongside conventional qualifications as part of our holistic approach to recruitment.