Bilingual Investigation Analyst

5 months ago

Montréal, Canada Manulife Full time

We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and meaningfully challenged, we all thrive. Discover how you can grow your career, make impact and drive real change with our Winning Team today.

**Working Arrangement**

Hybrid

Do you have an investigative spirit and want to push your analytical skills and knowledge of the Canadian Health Care Industry to the next level? If so, Manulife’s Investigation Analyst, Health and Dental Claims Risk Management position might be for you.

**The opportunity**

Manulife’s Group Benefits Health and Dental Claims Risk Management department is a diverse and dynamic team delivering a broad range of services in support of key operational objectives. Our responsibilities include digital claims risk management, claims abuse management and monitoring programs, fraud investigations, data analytics, and claims experience management. The effective management of health and dental claims experience is imperative to the success of the group benefits operations.

The Investigation Analyst will draw on their in-depth analytical skills, investigative mindset, customer focus, group benefits background and understanding of the Canadian Healthcare environment/regulation to help manage ongoing priorities in the delivery of risk management.

A key focus of the Investigation Analyst is the prevention, detection, and investigation of fraud and abuse specific to health care providers. This role will proactively identify risk, champion mitigation strategies, conduct provider investigations and take actions to protect Manulife benefit plans from fraud. The role may liaise externally with industry contacts and vendors, and internally with Legal, Compliance, Advanced Analytics, Marketing, Customer Service, Client Relations, Ombudsman and the Field as needed.

**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

**How will you create impact?**
This role reports to the Senior Manager, Fraud Risk Management, and helps to protect plan sponsors and members from the negative impacts of claims fraud. This role is focused on provider risk mitigation, which is a key part of the foundation for our investigation programs and a vital part of claims risk management.

**What motivates you?**
- You obsess about customers, listen, engage and act for their benefit.
- You think big, with curiosity to discover ways to use your agile approach and enable business outcomes.
- You thrive in teams and enjoy getting things done together.
- You take ownership and build solutions, focusing on what matters.
- You do what is right, work with integrity and speak up.
- You share your humanity, helping us build a diverse and inclusive work environment for everyone.

**What we are looking for**
- Knowledge of Group Benefits
- Knowledge of the Canadian healthcare environment, service delivery model and regulation
- University degree or equivalent work experience
- 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
- Demonstrated 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

**What can we offer you?**
- A competitive salary and benefits packages.
- A growth trajectory that extends upward

  • Bilingual Investigation Analyst

    5 months ago

    Montréal, Canada Manulife Full time

    We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and...

  • Bilingual Field Investigation Specialist

    4 months ago

    Montréal, Canada Definity Financial Corporation Full time

    Job ID : 6811 Category : Claims Brand : Definity Regular/Temporary : Regular Fulltime/Parttime : Full Time Location : Montreal, Canada Definity includes some of Canada’s most long-standing and innovative insurance brands, including Economical Insurance, Sonnet Insurance, Family Insurance Solutions, and Petline Insurance. With strong roots that date back...

  • Bilingual SAP Analyst

    5 months ago

    Montréal, Canada Auum solutions Full time

    _**Applicant must be in Quebec**_ **Title**: Bilingual SAP Analyst - Senior **Location**:Montreal - 1 day/week in person required **Duration**:6+ months **Introduction**: Join a rock-solid organization as our client’s next Bilingual SAP Analyst - Senior and sit at the center of projects that drives decisions. You’ll help one of Canada's most trusted...

  • Bilingual Claims Investigator Siu

    5 months ago

    Montréal, Canada Echelon Insurance Full time

    **About Us**: Echelon Insurance provides Personal and Commercial Specialty Insurance solutions to protect Canadian families and businesses across Canada, through our trusted network of Broker partners. Echelon is a member of the CAA Club Group of Companies, and is an equal opportunity employer who offers a professional environment that champions...

  • Analyst, Investigations L Enquêteur, Soutien Aux

    4 months ago

    Montréal, Canada Royal Bank of Canada Full time

    **Come Work with Us!** At RBC, our culture is deeply supportive and rich in opportunity and reward. You will help our clients thrive and our communities prosper, empowered by a spirit of shared purpose. Whether you’re helping clients find new opportunities, developing new technology, or providing expert advice to internal partners, you will be doing work...

  • Bilingual Claims Verification Analyst

    4 weeks ago

    Montréal, QC, Canada Manulife Full time

    The Claims Verification Analyst is responsible for supporting health and dental claims fraud risk controls by authenticating claim submissions, identifying, and investigating issues for action and resolution, and escalating key control issues to the claims risk management team. The Claims Verification Analyst will conduct health and dental claims audits by...

  • Bilingual Functional Analyst

    4 months ago

    Montréal, Canada Auum solutions Full time

    _**Applicant must be in Quebec**_ Title**:Bilingual Functional analyst** Location**:Montreal, 1x per week at the office required** Mandate duration**:12+ months** - Bilingual with French and English. Required: (for each requirement, specify the tool, the tasks performed and the location where they were used) - Specify and list these experiences...

  • Bilingual (English/french) Data Entry Analyst

    2 months ago

    Montréal, QC, Canada Procom Full time

    Au nom de notre client dans le secteur bancaire, PROCOM recherche un Analyste de saisie de données bilingue (anglais/français), Hypothèques (MS Excel) Analyste de saisie de données bilingue (anglais/français), Hypothèques (MS Excel) - Description du poste - Département : Prêts personnels - Impression et signature de documents - Traitement des...

  • Loss Prevention Investigator

    5 months ago

    Montréal, Canada Walmart Canada Full time

    **Position Summary... **:To conduct internal (associate) and external (customer) investigations related to financial & Physical loss and support the greater Loss Prevention team and its strategy. **What you'll do...**: 1. Conducts internal investigations involving Associates (i.e.: malicious behavior, policy violations, etc.) under the direction of the...

  • Loss Prevention Investigator

    5 months ago

    Montréal, Canada Walmart Canada Full time

    **Position Summary... **:To conduct internal (associate) and external (customer) investigations related to financial & Physical loss and support the greater Loss Prevention team and its strategy. **What you'll do...**: 1. Conducts internal investigations involving Associates (i.e.: malicious behavior, policy violations, etc.) under the direction of the...

  • Loss Prevention Investigator

    5 months ago

    Montréal, Canada Walmart Canada Full time

    **Position Summary... **:To conduct internal (associate) and external (customer) investigations related to financial & Physical loss and support the greater Loss Prevention team and its strategy. **What you'll do...**: 1. Conducts internal investigations involving Associates (i.e.: malicious behavior, policy violations, etc.) under the direction of the...

  • Part-time Data Quality Analyst

    5 months ago

    Montréal, Canada owl.co Full time

    Owl.co is a software company that enables insurers to fight illegitimate claims at scale while removing human bias from the process. Our clients are the top insurance companies across North America, and they are achieving incredible results through our AI-powered, evidence-based platform. We are on a mission to bring state-of-the-art ML and NLP methods to...

  • Bilingual Occupational Health and Safety Analyst

    4 months ago

    Montréal, Canada LifeWorks Full time

    TELUS Health and LifeWorks have recently come together to leverage the power of technology and our caring cultures to further progress our shared goal of building a healthier and friendlier future for all. As a global-leading health and well-being provider - encompassing physical, mental and financial health - TELUS Health is improving health outcomes for...

  • Bilingual Occupational Health and Safety Analyst

    5 months ago

    Montréal, Canada LifeWorks Full time

    TELUS Health and LifeWorks have recently come together to leverage the power of technology and our caring cultures to further progress our shared goal of building a healthier and friendlier future for all. As a global-leading health and well-being provider - encompassing physical, mental and financial health - TELUS Health is improving health outcomes for...

  • Analyste Support Bureautique- Bilingue

    4 months ago

    Montréal, Canada Compugen Inc Full time

    **Job Title** - Analyste Support Bureautique - Bilingue **Vacancy No** - VN6896 **Work Location** - Montreal, QC **Base Pay Range** - To be discussed during the recruitment process **Job Details** **Position: Analyste Support Bureautique - Bilingue** **Location**: **Montréal, QC** **Position : Analyste Support Bureautique -...

  • Bilingual Business Analyst

    4 months ago

    Montréal, Canada Auum solutions Full time

    **Title**: Bilingual Business Analyst **Location**:Montreal - hybrid model - face-to-face availability required 1 day per week **Type**:Contract (6+ months) **Introduction**: Join a rock-solid organization as our client’s next Business Analyst and sit at the center of projects that drives decisions. You’ll help one of Canada's most trusted consulting...

  • Manager of Investigation

    3 weeks ago

    Montréal, QC, Canada Staples Full time

    **Some of what you will do**: Under the general supervision of the Senior Manager, Asset Protection Operations, thoroughly investigates internal and external Telecom (Wireless, Internet, TV and home phone) incidents of interest to the Company. This includes interviews as necessary, detailed report writing, and communication with law enforcement officials,...

  • Bilingual Occupational Health and Safety Analyst

    4 months ago

    Montréal, Canada LifeWorks Full time

    TELUS Health is empowering every person to live their healthiest life. Guided by our vision, we are leveraging the power of our leading edge technology and focusing on the uniqueness of each individual to create the future of health. As a global-leading health and well-being provider - encompassing physical, mental and financial health - TELUS Health is...

  • Director, Professional Services

    4 months ago

    Montréal, Canada Latitude Management Full time

    **About Latitude** We help organizations implement best practices to ensure healthy and harmonious environments. Our work includes investigations and neutral assessments, mediation, training and other interventions related to respect and civility, diversity and inclusion within organizations. Our multidisciplinary team includes legal and human resources...

  • Analyste Du Centre de Services Bilingue

    4 months ago

    Montréal, Canada Compugen Inc Full time

    **Job Title** - Analyste du Centre de Services Bilingue **Vacancy No** - VN6039 **Work Location** - Montreal, QC **Base Pay Range** - To be discussed during the recruitment process **Job Details** **Position: Analyste du Centre de Services Bilingue** **Location**: **Montréal** **Position : Analyste du Centre de Services Bilingue** *** **Emplacement :...