Investigation Analyst in Provider Risk at Manulife focusing on fraud prevention, detection, and investigation in the healthcare sector, working with internal teams and stakeholders.
About the role
- Operational Risk Officer responsible for monitoring fraud trends and optimizing fraud management processes. Collaborates with various stakeholders to enhance operational effectiveness.
Responsibilities
- Monitor and analyze emerging account-opening fraud trends across the industry to inform and guide strategic priorities for Business, Operations, and Analytics teams
- Collaborate with cross-functional teams to drive continuous improvement and optimization of fraud management processes
- Establish and maintain strong partnerships with stakeholders in Policy, Analytics, Operations, Process Integration, and Client Experience to facilitate clear, timely, and comprehensive communication
- Initiate and lead efforts to streamline operational processes, enhancing fraud decision effectiveness, reducing operational expenses, and improving the overall client experience
- Provide expert support for project initiatives, specifically acting as the primary Policy Subject Matter Expert (SME) for all acquisition-related projects
- Manage relationships with account-opening vendors, including regular performance evaluations and strategic engagement to ensure optimal service delivery and alignment with business objectives
- Establishes and oversees the application of operational risk policies, technology and tools, and governance processes to create lasting solutions for minimizing losses from failed internal processes, inadequate controls, and emerging risks
- Independently assess’ risks and drive actions to address the root causes that persistently lead to operational risk losses by challenging both historical and proposed practices
- Governance and oversight may include (not limited to) technology operational risk, risk for example
- Serves as a subject matter expert for Issues Management (KPI/KRI/Corrective Action Plans)
- Resolves transactional level escalations coming from the vendor or internal partners
- Analyzes a multitude of scorecards/performance management tools in an attempt to mitigate exposure (risk/financial/regulatory)
- Monitors goals are met through performance, risk and relationship oversight of our extended supply chain
- Collaborates to resolve any issues which fall within the terms of the contract
- Develops and maintains relationships across the business users and Lines of Defense to better understand and deliver customer requirements by responding to changes in the internal and external business environment
- Has the ability to operate with a limited level of direct supervision
- Can exercise independence of judgement and autonomy
- Acts as SME to senior stakeholders and /or other team members
- Appropriately assess risk when business decisions are made, demonstrating particular consideration for the firm's reputation and safeguarding Citigroup, its clients and assets, by driving compliance with applicable laws, rules and regulations, adhering to Policy, applying sound ethical judgment regarding personal behavior, conduct and business practices, and escalating, managing and reporting control issues with transparency.
Requirements
- 6-10 years experience navigating and networking across an enterprise utilizing internal and external resources
- Third Party Oversight/Vendor Oversight experience preferred
- Business writing experience preferred
- In depth knowledge of Retail Bank processes and technology platforms
- Proven ability to balance effective fraud risk mitigation strategies with a commitment to maintaining an excellent customer experience
- Strong understanding of the complete fraud lifecycle, from prevention and detection to investigation and resolution
- Demonstrated capability to identify and implement specific process enhancements within fraud operations to address customer pain points and improve overall customer satisfaction
- Attention to detail combined with strong organizational and analytical skills
- Excellent written and verbal communication skills, with the ability to convey complex information clearly and concisely
- Proficient time management skills and the ability to work effectively under pressure and meet tight deadlines in a dynamic, fast-paced environment
- Demonstrated ability to influence and collaborate effectively with various stakeholders, including senior management.
Benefits
- medical, dental & vision coverage
- 401(k)
- life, accident, and disability insurance
- wellness programs
- paid time off packages, including planned time off (vacation), unplanned time off (sick leave), and paid holidays
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