Director / Associate Director, Claims

Manulife/John Hancock; Hong Kong; Hybrid; HKD 900,000 - 1,200,000; Full time

Job summary

Manulife/John Hancock is seeking a seasoned Director/Associate Director to oversee end-to-end Life & Health claims operations, including reimbursement and cashless/PA processes. You will handle complex cases, complaints, and regulatory interactions, while driving risk management and service excellence.

The role requires leadership of remote teams, adherence to policies, and collaboration with stakeholders to optimize claims initiatives.

Qualifications

• Degree holder or above.
• At least 10 years of claims experience in Individual and/or Group Life & Health business.
• Experience in FWA management, complaints handling and regulatory interactions is strongly preferred.
• Professional qualifications (e.g. FLMI) are preferred.
• Proficient knowledge of insurance products and regulatory requirements (AML, FATCA, CRS, local insurance regulations).
• Able to work independently under tight schedule and lead remote teams.
• Strong attention to detail.
• Excellent interpersonal, stakeholder management and communication skills, including complaint resolution and negotiation.
• Strong analytical, problem‑solving and conflict resolution capabilities.
• Proficiency in MS Word, MS Excel, MS PowerPoint, and Chinese Word Processing.
• Good command of English, Chinese, and Mandarin, both spoken and written.

Responsibilities

• Oversee end-to-end claims operations across reimbursement and cashless processes.
• Handle complex cases, complaints and appeals; ensure fair resolution.
• Monitor performance and drive improvements for service excellence.
• Adjudicate and review complex claims per policy and regulatory requirements.
• Update manuals and guidelines reflecting best practices for reimbursement and cashless claims.
• Lead handling of complex complaints and disputes; liaise with regulators as needed.
• Collaborate with Customer Service to study pain points across journeys and implement actions.
• Support risk management with focus on higher‑risk and FWA cases.
• Train claims assessors on new guidelines and cashless processes.

Skills

Stakeholder management

Complaint resolution

Regulatory knowledge

Analytical thinking

Communication skills

Education

Bachelor's degree or above

FLMI (preferred)

Tools

MS Word

MS Excel

MS PowerPoint

Chinese Word Processing

Job description

Overview

We are seeking a seasoned and strategic Director / Associate Director to support the Team Manager in overseeing the end‑to‑end Claims BAU for both Group and Individual Life & Health businesses, covering reimbursement and cashless / pre‑authorization (PA) processes. This role is accountable for complex, escalated case and complaint handling, ownership of key controls, and effective management of rising claim volumes and FWA (Fraud, Waste & Abuse) activities. The focus is on delivering exceptional claims experience, managing risk, supporting distribution channels, and fostering team development. This role also involves collaborating with various stakeholders to drive operational and service excellence in claims initiatives.

Key Responsibilities

Claims Operations

Support the team manager in overseeing the end‑to‑end claims operations across reimbursement and cashless processes, ensuring fair, efficient and transparent claims handling. Collaborate with stakeholders to manage complex cases, complaints, and appeals, ensuring smooth professional resolution. Monitor operational performance and drive improvement initiatives to sustain service excellence amid rising workloads. Continuously enhance business processes, workflows and capacity to support business growth. Adjudicate and review complex or escalated claims, both major and minor, in accordance with policy provisions and regulatory requirements. Maintain and regularly update manuals and guidelines to reflect current best practices for both reimbursement and cashless claims.

Regulatory Matters & Customer Experience

Lead the handling of complex complaints and claim disputes, ensuring fair outcomes and clear communication. Liaise with regulatory bodies on claims‑related matters, ensuring timely, accurate responses and alignment with regulatory requirements. Collaborate closely with the Customer Service Team to study customer pain points across reimbursement and cashless/PA claims journeys, and co‑develop improvement actions. Regularly review claims communications and operational practices to enhance overall customer experience and NPS outcome.

Claims Risk Management

Collaborate with the Claims Risk Manager and Chief Medical Officer to ensure the claims practices are consistent, prudent, customer‑centric, and aligned with the company's risk appetite and market standards. Ensure consistency and integrity in the claims assessment and decision‑making across the reimbursement and cashless claims teams. Strengthen risk‑based assessment frameworks, with a focus on higher‑risk and FWA‑suspected cases. Ensure the timely and competent training of claims assessors on new or revised guidelines, including the nuances of cashless claims processing.

Required Qualifications

• Degree holder or above.
• At least 10 years of claims experience in Individual and/or Group Life & Health business.
• Experience in FWA management, complaints handling and regulatory interactions is strongly preferred.
• Professional qualifications (e.g. FLMI) are preferred.
• Proficient knowledge of insurance products and regulatory requirements (e.g. AML, FATCA, CRS, local insurance regulations).
• Able to work independently under tight schedule and lead remote teams.
• Strong attention to detail.
• Excellent interpersonal, stakeholder management and communication skills, including complaint resolution and negotiation.
• Strong analytical, problem‑solving and conflict resolution capabilities.
• Proficiency in MS Word, MS Excel, MS PowerPoint, and Chinese Word Processing.
• Good command of English, Chinese, and Mandarin, both spoken and written.

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.

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 https://www.manulife.com/en/about/our-story.html.

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 [e-mail].

Working Arrangement Hybrid

We're Manulife. And we’re on a mission to make decisions easier and lives better. Better is what drives us. It’s what inspires us to find new ways to support customers and colleagues in living longer and healthier lives. It’s the reason we’re dedicated to investing in digital innovation and industry-leading AI, and accelerating a sustainable and economically inclusive future. Joining us means you’ll be empowered to learn and grow your career. We’ll recognize and support you in a flexible environment where well‑being and inclusion are more than just words. And as part of our global team, you’ll help shape the future you want to see – and discover that better can take you anywhere you want to go. We’re proud of our accomplishments and recognition. Recent awards include: 2026 Gallup Exceptional Workplace Award Winner Manulife Named one of Forbes World’s Best Employers 2025 Financial Times World’s Best Employers Asia-Pacific 2026 We’ve been recognized as one of Canada’s Top 100 Employers 2026 #1 Life Insurer for AI Maturity by Evident 2026.