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Investigation Analyst – Provider Risk
ManulifeInvestigation Analyst managing health claims risk at Manulife involved in fraud prevention and analytical support. Collaborating with stakeholders to ensure effective risk management practices.
About the role
Key responsibilities & impact- 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
- Conduct interviews of plan members, providers of service and others
- Create written audits and other correspondence to plan members, providers of service and others
- 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
Requirements
What you’ll need- Knowledge of Group Benefits
- Knowledge of the Canadian healthcare environment, service delivery model and regulation
- University degree or equivalent work experience
- Bilingualism (English and French) is an asset.
- CFE designation is an asset
- Knowledge of fraud and abuse risk, and techniques to manage risk
- Strong research, problem solving and decision-making skills
- Intermediate or higher data analysis skills with expertise using Excel and other data mining software
- Demonstrated investigation skills with attention to detail
Benefits
Comp & perks- Health insurance
- Dental insurance
- Mental health support
- Vision insurance
- Short- and long-term disability
- Life insurance
- Employee and family assistance plans
- Retirement savings plans
- Paid time off including holidays and vacation
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data profilingdata analysisinvestigation techniquesresearch skillsproblem solvingdecision-makingdata miningExcel
Soft Skills
leadershipcommunicationpresentation skillsattention to detail
Certifications
CFE designation