Senior Associate, managing credit risk policy lifecycle at Capital One. Collaborating with stakeholders to ensure compliance and enhance risk frameworks.
About the role
- Investigation Analyst managing fraud and risk in healthcare claims for Manulife. Focusing on plan member risk mitigation involving fraud prevention and investigations.
Responsibilities
- 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
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