Investigation Analyst

**_Are you looking for a supportive, collaborative workplace with great teams and inspiring leaders? You’ve come to the right place. We’re looking for ambitious people who share our values and want to make every day better for people around the world. If this sounds like you, and the career below sounds exciting, we’d like to hear from you. _**

**Working Arrangement**

Hybrid

Do you have a passion for investigations and want to push your analytical skills and knowledge of the Canadian healthcare Industry to the next level? If so, Manulife’s Investigation Analyst, Provider Risk Management position might be for you.

**The Opportunity**:
As one of Canada’s leading health and dental benefits providers, we are committed to improving our members’ health and well-being, while keeping costs down. Manulife’s Health and Dental Claims Risk Management department is focused on managing risk through preventing, detecting and investigating fraud and abuse, all in an effort to protect our benefit plans from risk. We are looking for a dynamic, risk minded individual to join our Investigation Services team.

**What You’ll Do**:

- Perform risk-based data profiling and analysis to identify outliers requiring further investigation
- Support audit programs; coordinating, assessing, and making decisions on investigations including the identification of high-risk providers and suspicious transactions through fraud data analytics addressing existing, new and emerging risk
- Take initiative and lead investigations to successful conclusion
- Conduct interviews of plan members, providers of service and others
- Prepare and file regulatory complaints
- Support investigators with the preparation of criminal complaints for submission
- Create written audits and other correspondence to plan members, providers of service and others
- Identify fraud trends and offer solutions to mitigate new, key risk indicators
- Train and educate internal and external parties on ways to manage risk through fraud prevention
- Engage, interact and consult with various internal contacts such as Customer Service, Legal, Client Relations, Medical Consultants, Regional Group Office and external customers such as Health Practitioner Regulatory Bodies, Colleges and Associations, and Plan Sponsors
- Lead and support key investigative projects

**What we are looking for**
- University degree or equivalent work experience
- Knowledge of Group Benefits
- Knowledge of fraud and abuse risk and techniques to manage risk
- Strong research, problem solving and decision-making skills
- Previous investigation experience (within the Health and Dental insurance industry is an asset)
- Effective case management including clear documentation of evidence and case findings
- Ability to manage contentious interactions with various stakeholders
- Excellent oral and written communication skills
- Data analysis skills including advanced knowledge of Microsoft Excel
- Demonstrated investigation experience with attention to detail
- Knowledge and understanding of contractual language, administration guidelines and provincial and federal legislation as it applies to the Canadian healthcare environment
- Ability to be critical and aggressive in managing audit and investigative activities
- Organizational skills with the ability to manage multiple, conflicting priorities

**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 partners and has a positive social and environmental impact.

**About John Hancock and Manulife**

**Manulife is an Equal Opportunity Employer