Investigation Analyst – Member Risk

Manulife; Kitchener; Hybrid; CAD 44,000 - 75,000; Full time

Job summary

A leading financial services provider in Canada is seeking an individual to perform risk-based analysis and lead audit programs. The role involves significant interaction with various stakeholders, conducting interviews, and preparing written reports. Candidates should have knowledge of Group Benefits and the Canadian healthcare system. Competitive salary and customizable benefits are offered in a hybrid working arrangement.

Benefits

Health, dental, and vision insurance

Short- and long-term disability coverage

Generous paid time off program

401k and retirement savings plans

Qualifications

• Experience with investigations and criminal complaints.
• Ability to manage various stakeholder interactions.
• Travel may be required.

Responsibilities

• Perform risk-based data profiling and trend analysis.
• Lead audit programs and make decisions on investigations.
• Create written audits and communicate with stakeholders.

Skills

Knowledge of Group Benefits

Knowledge of the Canadian healthcare environment

Strong research and problem-solving skills

Excellent oral and written communication skills

Intermediate data analysis skills

Demonstrate investigation skills

Education

University degree or equivalent work experience

Tools

Excel

Data mining software

Job description

Position Responsibilities :

• Perform risk-based data profiling and analysis to identify trends and outliers in various categories for further review and investigation
• Lead and support audit programs; coordinating, assessing, and making decisions on investigations
• Take initiative and lead investigations to successful conclusion including the preparation of criminal and regulatory complaints
• Conduct interviews of plan members, providers of service and others
• Create written audits and other correspondence to plan members, providers of service and others
• Engages, interacts and consults with various internal contacts such as Customer Service, Legal, Client Relations, Medical Consultants, Regional Group Office and external stakeholders such as Health Practitioner Regulatory Bodies, Colleges and Associations, and Plan Sponsors
• Lead, support and implement key investigative projects
• Comfortable delivering effective presentations to new and existing clients
• Travel may be required for this role including the ability to work outside of core working hours

Required Qualifications :

• Knowledge of Group Benefits
• Knowledge of the Canadian healthcare environment, service delivery model and regulation
• University degree or equivalent work experience

Preferred Qualifications :

• CFE designation is an asset
• Knowledge of fraud and abuse risk, and techniques to manage risk
• Strong research, problem solving and decision-making skills
• Ability to manage contentious interactions with various stakeholders
• Excellent oral communication (both phone and face to face) and written communication skills
• Intermediate or higher data analysis skills with expertise using Excel and other data mining software
• Demonstrate investigation skills with attention to detail
• Ability to be creative, critical and aggressive in managing audit and investigative activities
• Organizational skills and the ability to manage multiple conflicting priorities

When you join our team :

We’ll empower you to learn and grow the career you want.

We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.

As part of our global team, we’ll support you in shaping the future you want to see.

#LI-HYBRID

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit .

Manulife is an Equal Opportunity Employer

At Manulife / John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife / John Hancock policies. To request a reasonable accommodation in the application process, contact .

Referenced Salary Location

Montreal, Quebec

Working Arrangement

Hybrid

Salary range is expected to be between

$44,775.00 CAD - $74,625.00 CAD

If you are applying for this role outside of the primary location, please contact for the salary range for your location. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education / training. Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance.

Manulife offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption / surrogacy and wellness benefits, and employee / family assistance plans. We also offer eligible employees various retirement savings plans (including pension and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in Canada includes holidays, vacation, personal, and sick days, and we offer the full range of statutory leaves of absence. If you are applying for this role in the U.S., please contact for more information about U.S.-specific paid time off provisions.