Information Technology - Drug Program Specialist

Accerta•Toronto, ON

9d•CA$70,000 - CA$85,000•Hybrid

About The Position

The Drug Program Specialist supports the implementation and ongoing evolution of the drug benefits claims adjudication platform. The role provides expertise in drug benefit policy, data, formularies, pricing, and pharmaceutical standards to ensure accurate adjudication, regulatory compliance, and alignment with business needs. As the subject matter expert in drug program administration, the Specialist helps define drug plans, benefit rules, supports testing and issue resolution, and works with cross-functional teams and external partners to shape how drug claims are adjudicated and managed. The role also supports the Product Director by helping prioritize work, inform decisions, and escalate issues as needed.

Requirements

8+ years of experience in drug benefits administration, claims adjudication, or program delivery.
Knowledge of provincial drug formularies, pricing structures, drug data, and pharmaceutical terminology.
Experience with adjudication systems, including rules, workflows, and benefit structures.
Strong analytical skills and attention to detail in interpreting policy and translating it into system requirements.
Strong written and verbal communication skills, with the ability to work effectively across technical and business teams.
Experience working in agile or iterative environments, including backlog refinement and sprint reviews.
Ability to manage competing priorities and adapt to changing business needs.

Nice To Haves

Experience supporting digital transformation or system implementation projects is an asset.

Responsibilities

Act as the internal expert on drug benefit rules, formulary and pricing updates, data ingestion, EDI, and policy alignment.
Partner with the Product Director and product team to define and maintain adjudication logic for drug claims, including DINs/PINs, compounds, limits, exclusions, coordination of benefits, deductibles, and co-payments.
Translate program and business needs into clear requirements, support platform configuration, create test scenarios, and lead UAT for drug benefit workflows and claims outcomes.
Work with clients, government stakeholders, internal teams, and external partners to validate rule configurations, confirm outcomes, and align the platform with program requirements.
Support issue triage during testing and post-launch, assess risks related to program rules and regulatory changes, recommend mitigation strategies, and help ensure operational readiness.
Monitor adjudication performance, maintain documentation, and communicate updates, impacts, and decisions to support operational continuity and cross-functional alignment.
Stay current on regulatory changes and industry trends in drug benefits to keep the platform compliant and future ready.

Benefits

Coverage begins on the employee's first day and includes a Health Care Spending Account and Personal Spending Account (depending on allocation).
Eligibility starts on the employee's first day, and a 5% employee contribution is matched by a 5% employer contribution.
Opportunities to increase your earnings.
in a company that promotes from within.
Time off to volunteer within our community
working environment with a laptop and two monitors.
A one-time payment of $750 included in the employee's first paycheck.
Access to Mental Health on Demand for employees and their dependents.
Includes Employee Assistance Program services.
Up to 8 hours of paid time off annually to volunteer in your community.
Opportunities to contribute to non-matching GRRSPs, TFSAs, and FHSAs, along with financial information sessions.
Tuition reimbursement for post-graduate courses, upon prior approval.
Employees can earn a $1,500 reward for successful referrals of other employees.