WHO WE ARE

AccertaClaim Servicorp Inc. (ACSI) and its subsidiary, Accerta Services Inc. (ASI), both known as Accerta, which is a is a social enterprise, that manages dental, vision, drug, and healthcare benefits programs exclusively for government and social services agencies in Canada. Our targeted experience and innovative technology provide reliable service, process continuity, cost savings, as well as accurate and insightful data that enables governments to make informed strategic decisions, reducing stress on the healthcare system through streamlined administration.

Accerta is a Certified B Corporation which is a testament to the values on which we’ve built our business: serving our customers, caring for our employees, and supporting our community and the environment. Being part of the B Corp movement means we’re committed to continual improvement and making business a force for good. Thank you to our team and stakeholders who have helped us achieve this significant milestone!

JOB TITLE: Drug Program Specialist

EMPLOYMENT TYPE: Full-time, Permanent, Hybrid

ABOUT THIS OPPORTUNITY

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.

 ACCOUNTABILITIES

• Drug Benefits Expertise & Policy Application: 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.
• Requirements, Configuration & Testing: Translate program and business needs into clear requirements, support platform configuration, create test scenarios, and lead UAT for drug benefit workflows and claims outcomes.
• Stakeholder Collaboration & Validation: Work with clients, government stakeholders, internal teams, and external partners to validate rule configurations, confirm outcomes, and align the platform with program requirements.
• Issue Resolution, Risk & Readiness: 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.
• Performance, Documentation & Communication: Monitor adjudication performance, maintain documentation, and communicate updates, impacts, and decisions to support operational continuity and cross-functional alignment.
• Regulatory & Industry Awareness: Stay current on regulatory changes and industry trends in drug benefits to keep the platform compliant and future ready.

QUALIFICATIONS

Experience:

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

Skills and Competencies:

• 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.

 ANNUAL SALARY: $70,000 to 85,000

PERFORMANCE BONUS: Up to 10% of annual salary

WHAT WE OFFER

• Group Benefits: Coverage begins on the employee’s first day and includes a Health Care Spending Account and Personal Spending Account (depending on allocation).
• Pension Plan: Eligibility starts on the employee’s first day, and a 5% employee contribution is matched by a 5% employer contribution.
• Performance-based incentive programs: Opportunities to increase your earnings.
• Growth Opportunities:  in a company that promotes from within.
• Volunteering: Time off to volunteer within our community
• Hybrid Work Environment: working environment with a laptop and two monitors.
• Home Office Stipend: A one-time payment of $750 included in the employee’s first paycheck.
• Mental Health Support: Access to Mental Health on Demand for employees and their dependents.
• Member Assistance Program: Includes Employee Assistance Program services.
• Community Volunteering: Up to 8 hours of paid time off annually to volunteer in your community.
• Financial Wellness: Opportunities to contribute to non-matching GRRSPs, TFSAs, and FHSAs, along with financial information sessions.
• Education Reimbursement: Tuition reimbursement for post-graduate courses, upon prior approval.
• Employee Referral Reward: Employees can earn a $1,500 reward for successful referrals of other employees.

FLEXIBLE WORK ARRANGEMENT:

Employees are expected to work on-site at least once per month at our Toronto office (4 New Street., Toronto, ON), with additional in-office days as required based on business needs. Hybrid schedules are determined collaboratively between employees, managers, and teams.

HOW TO APPLY

We accept applications submitted via our Dayforce Portal – Click this link to apply. Please note that we use AI tools to support and enhance our recruitment process, including scribing tools during interviews. Artificial intelligence (AI), however, is not used to screen candidates.

Rest assured that your application will be reviewed thoroughly by our hiring team.

INCLUSION AND EQUAL OPPORTUNITY EMPLOYMENT

Accerta is an equal opportunity employer and committed to fostering diversity and inclusion in the workplace. We are committed to fair employment practices, and all qualified applicants will receive consideration for employment. We offer accommodation for applicants with disabilities, as required throughout the recruitment process. Reasonable accommodation is also available on request for candidates taking part in all aspects of the selection process.

To request accommodation, please contact [email protected].

We appreciate your interest in working with us; however, only those applicants selected for interviews will be contacted.

Final candidates for this position may be required to undergo a security screening, including criminal records check, judicial matters check, vulnerable sector screening and employment reference check.  

To learn more about us please go to: www.accerta.ca