Intermediate Dental Investigation Specialist

4 weeks ago

Waterloo, 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

**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

**Job Requirements**:

- University degree or equivalent, will be considered as an asset
- Knowledge of Group Benefits
- Knowledge of the Canadian healthcare environment, service delivery model and regulation
- Knowledge of dental codes and billing practices and dental Assisting or Dental Hygiene is an asset
- Knowledge of fraud and abuse risk, and techniques to manage risk
- Bilingual is an asset
- 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 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

**Competencies**:

- We Work as One
- Influence and Persuasion
- Compelling Communication
- Collaboration
- We Question and Innovate
- Adaptability
- Knowing the Business
- Technology Savvy
- We Own our Future
- Solution Focused
- Executing with Excellence
- General
- Passion to succeed
- Ability to thrive through ambiguity, multiple competing tasks and changing priorities
- Ability to maintain a balance of confidence and approachability
- Positivity

**What can we offer you?**
- A competitive salary and benefits packages.
- A growth trajectory that extends upward and outward, encouraging you to follow your passions and learn new skills.
- A focus on growing your career path with us.
- Flexible work policies and strong work-life balance.
- Professional development and leadership opportunities.

**Our commitment to you**
- Values-first culture
- We lead with our Values every day and bring them to life together.
- Boundless opportunity
- We create opportunities to learn and grow at every stage of your career.
- Continuous innovation
- We invite you to help redefine the future of financial services.
- Delivering the promise of Diversity, Equity and Inclusion
- We foster an inclusive workplace where everyone thrives.
- Championing Corporate Citizenship
- We build a business that benefits all stakeholders and has a positive social and environmental impact.

**About John Hancock and Manulife**

**Manulife is an Equal Opportunity Employer**

**Salary & Benefits**

The annual base salary for this role is listed below.

**Primary Location**

Waterloo, Ontario

**Salary range is expected to be between**

$41,025.00 CAD - $68,375.00 CAD

Manulife offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short

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