Manager, Special Investigations Unit

**Job Description**:
As the Manager, Special Investigations Unit (SIU), you will lead the team of investigators responsible for field and undercover investigation of suspected plan member and provider Group Health & Dental claims fraud. You will contribute to Canada Life’s mitigation of fraud risk for its Group Customers.

You will be responsible for ensuring that investigations are completed in a timely manner, high-quality investigative results are delivered, the team takes creative and evolving approaches to investigations, and timely and insightful reporting on investigative outcomes is surfaced.

**What you will do**
- Manage the execution of investigations of suspected external Group Health & Dental claims fraud committed by plan members, providers, and those associated to the provision of healthcare services/supplies.
- Ensure that Investigations are conducted as per protocols and the Fraud Risk Management Operating Standard, and with a high degree of professionalism.
- On the basis of program outcomes, innovate and expand the tactics employed by the SIU to ensure investigations are effective.
- Through collaboration with others in the Fraud Management organization and use of a risk-based approach, prioritize investigations against staff resources.
- Contract management and direction for external, contracted investigators, as required
- Develop and manage safety and training programs for field investigators.
- Participate in root cause analyses on cases of confirmed fraud, and support remediation and corrective action in conjunction with internal stakeholders and partners.
- Communicate investigation results in a thorough, objective, and timely fashion to internal stakeholders.
- Establish and maintain reporting metrics to permit evaluation of the effectiveness of investigations.
- Primary point of contact (including accountability for making referrals) for external agencies including Law Enforcement, colleges, licensing bodies, and regulatory agencies as it relates to investigations of Group Health & Dental claims fraud.
- Testify as an expert in legal proceedings related to investigations.
- Participate on fraud risk initiatives, committees, and working groups across the organization and at industry.
- Ensures the program operations deliver on strategic objectives of the Fraud Management program; stay current on industry, fraud, risk, legal and litigation trends
- Responsible for hiring, performance management, annual salary adjustments, training plans, development, mentoring and coaching of staff.

**What you will bring**
- Post-secondary degree in justice studies or related field.
- 10 years of experience in investigation and/or investigative leadership, with 5 years of experience in specific, full-time Fraud investigations.
- Experience with the criminal justice and civil legal system.
- Prior experience in insurance, forensic accounting, commerce, or criminology is an asset.
- Designation as a Certified Fraud Examiner (CFE) is an asset.
- Superior verbal and written communication skills.
- Highly organized and able to multi-task in a fast-paced environment.
- Excellent analytical, problem solving and decision-making skills.
- Advanced Microsoft Office Skills (Excel, Word, PowerPoint, Access).
- Bilingual English-French is an asset.
- ** Enhanced Security Screening is a requirement of this position.**

**Be your best at Canada Life

Being a part of Canada Life means you have a voice. This is a place where your unique background, perspectives and talents are valued, and shape our future success.

You can be your best here. You’re part of a diverse and inclusive workplace where your career and well-being are championed. You’ll have the opportunity to excel in your way, finding new and better ways to deliver exceptional customer and advisor experiences.

***

Together, as part of a great team, you’ll deliver on our shared purpose to improve the well-being of Canadians. It’s our driving force. Become part of a strong and successful company that’s trusted by millions of Canadians to do the right thing.

**We are one of Canada's top 100 employers**
- Canada Life serves the financial security needs of more than 13 million people across Canada, with additional operations in Europe and the United States. As members of the Power Financial Corporation group of companies, we’re one of Canada’s leading insurers with interests in life insurance, health insurance, investment and retirement savings. We offer a broad portfolio of financial and benefit plan solutions for individuals, families, businesses and organizations._
- We are committed to providing an inclusive, accessible environment, where all employees and customers feel valued, respected and supported. We are dedicated to building a workforce that reflects the diversity of the communities in which we live, and to creating an environment where every employee _
- has the opportunity to_
- reach their potential._

**_
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