Fraud, Waste and Abuse Operations Lead Analyst

Location: Hybrid role based at 300–6985 Financial Drive, Mississauga, Ontario, Canada

Salary: CAD 60,000–68,000 per year

Company

Express Scripts Canada is a health benefits management company and a subsidiary of hirify.global, providing pharmacy, dental, and extended health benefits solutions for Canadian insurers, administrators, public-sector organizations, and patients.

What you will do

• Produce financial reports, analyze trends, and present findings to clients and internal stakeholders.
• Administer provider electronic withhold entries and monitor audit recoveries across benefits programs.
• Collect and analyze quality assurance data for client meetings, internal metrics, and program delivery consistency.
• Create forecasting tools to track key performance indicators and emerging trends.
• Maintain training documents, standard operating procedures, working instructions, and training records.
• Lead special projects, remedial training, process improvements, and resolution of escalated non-routine issues.

Requirements

• Post-secondary degree or equivalent work experience.
• 3+ years of related experience in pharmacy or dental benefits management, group insurance, or healthcare operations.
• Experience with quality assurance, data analysis, reporting, and handling large data sets.
• High proficiency in Microsoft Access, Excel, and data warehousing applications.
• Strong organizational, planning, critical-thinking, communication, and presentation skills.
• Successful employment is conditional on reference checks, background verification, and obtaining an Enhanced Reliability Clearance when required.

Culture & Benefits

• Competitive compensation, benefits, and pension plan.
• Career development and advancement opportunities.
• Culture focused on innovation, collaboration, integrity, and mutual respect.
• Flexible work options and wellness programs.
• Inclusive and accessible workplace with accommodation support.

Hiring process

• AI-powered tools may be used for video interviews, note-taking, and candidate scoring.
• Hiring managers and the Talent team review all AI-generated scores before making a decision.