Hybrid Investigation Analyst – Member Risk

Posted last month

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About the role

  • Perform risk-based data profiling and analysis to identify trends and outliers
  • 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 and providers
  • Engage and consult with various internal contacts and external stakeholders
  • Lead, support and implement key investigative projects

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 (preferred)
  • 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 and written communication skills
  • Intermediate or higher data analysis skills with expertise using Excel and other data mining software

Benefits

  • Health, dental, mental health, and vision insurance
  • Short- and long-term disability insurance
  • Life and AD&D insurance coverage
  • Adoption/surrogacy and wellness benefits
  • Employee/family assistance plans
  • Retirement savings plans including pension and global share ownership plan with employer matching contributions
  • Financial education and counseling resources
  • Paid time off including holidays, vacation, personal, and sick days
  • Full range of statutory leaves of absence

Job title

Investigation Analyst – Member Risk

Job type

Experience level

Mid levelSenior

Salary

CA$44,775 - CA$74,625 per year

Degree requirement

Bachelor's Degree

Location requirements

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