Investigation Analyst – Provider Risk
Manulife
full-time
Posted on:
Location Type: Hybrid
Location: Waterloo • Canada
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Salary
💰 CA$43,875 - CA$73,125 per year
About the role
- Perform risk-based data profiling to identify trends and outliers, leading investigations to successful conclusions, including preparing criminal and regulatory complaints.
- Lead and support audit programs by coordinating, assessing, and making decisions on investigations, and conducting interviews with plan members and service providers.
- Create written audits and correspondence for plan members and service providers, while engaging with internal and external stakeholders to ensure comprehensive investigation processes.
Requirements
- 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
Benefits
- health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage
- adoption/surrogacy and wellness benefits
- employee/family assistance plans
- various retirement savings plans (including pension and a global share ownership plan with employer matching contributions)
- financial education and counseling resources
- generous paid time off program including holidays, vacation, personal, and sick days, and the full range of statutory leaves of absence
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data profilingdata analysisinvestigation skillsrisk managementfraud detectionregulatory complianceaudit programsdecision-makingproblem-solvingattention to detail
Soft Skills
oral communicationwritten communicationorganizational skillsstakeholder managementcreativitycritical thinkingconflict managementinterpersonal skillsleadershipengagement
Certifications
CFE designationuniversity degree