Hybrid Team Manager – Claims Audit, Investigation Services

at Alberta Blue Cross

• Job title: Team Manager – Claims Audit, Investigation Services
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: Not specified
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Canada

About the role

• Team Manager overseeing audits and investigations for dental and healthcare providers at Alberta Blue Cross. Leading a team to ensure compliance with billing agreements and reporting findings.

Responsibilities

• Act as the primary resource for your assigned team, monitor audits and investigations, and ensure audits and investigations, including all reporting meet all required standards.
• Proactively address internal and external clients’ needs that are escalated to you and help your team to prioritize work items to meet client service standards.
• Responsible for the management of the day-to-day activities of team members including workload management, audit and/or investigative direction, coaching and mentoring.
• Establish and continuously enhance best practices guidelines for the successful delivery of the audits and investigations.
• Maintain a positive, collaborative team which inspires high productivity and encourages the generation of new ideas and enhanced work processes.
• Recommend and implement changes to processes, policies, and procedures to optimize service delivery and enhance productivity.
• Recruit, train, mentor, and coach team members, with an end goal of retaining a work force of the highest quality for both the team and our organization.
• Actively participate in the planning and implementation of Claims Audit and Investigation Services operational initiatives.

Requirements

• Post-secondary education preferred in police studies, criminal justice, law, commerce, or related studies.
• Comprehensive understanding of major case management principles.
• Ability to employ and train advanced investigative techniques.
• An audit or investigation designation such as ACFI or ACFE is required (candidates with extensive relative experience will be considered in lieu of education).
• Five years plus experience in investigations and/or auditing.
• Three years plus leadership experience is an asset.
• Exceptional communication skills, including written and verbal.
• Experienced in investigation interviewing.
• Commitment to quality customer service is required for success in this position.
• Ability to work well independently as part of a virtual team, with a strong sense of responsibility and accountability.
• Experience in the health care benefits industry is desirable.

Benefits

• Exceptional customer experience
• Community leadership
• Opportunities for career growth
• Inclusive employer