Senior Dental Investigative Analyst

Posted:
10/7/2024, 5:00:00 PM

Location(s):
Ontario, Canada ⋅ Kitchener, Ontario, Canada ⋅ Halifax, Nova Scotia, Canada ⋅ Nova Scotia, Canada ⋅ Waterloo, Ontario, Canada

Experience Level(s):
Senior

Field(s):
Data & Analytics

The Investigation Analyst, Investigation Services is responsible for applying Group Benefits and dental knowledge to identify, investigate and prevent dental fraud and abuse. Excellent customer service skills, problem-solving abilities and attention to detail are key attributes required for success in this role on the Dental Abuse Management Team.

Responsibilities

  • 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   

  • Take initiative and lead investigations to successful conclusions including the preparation of concern letters, criminal and regulatory complaints

  • Conduct interviews of plan members, providers of service and others

  • Create written audits and other correspondence to plan members, providers of service and others

  • Engage, interact, and consult with various internal contacts such as Customer Service, Legal, Client Relations, Medical Consultants, Regional Group Office and external stakeholders such as Health Practitioner Regulatory Bodies, Colleges and Associations and Plan Sponsors 

What motivates you?

  • You obsess about customers, listen, engage and act for their benefit.

  • You think big, with curiosity to discover ways to use your agile approach and enable business outcomes.

  • You thrive in teams and enjoy getting things done together.

  • You take ownership and build solutions, focusing on what matters. 

  • You do what is right, work with integrity and speak up.

  • You share your humanity, helping us build a diverse and inclusive work environment for everyone

What we are looking for

  • Knowledge of Group Benefits

  • Knowledge of the Canadian healthcare environment, service delivery model and regulation

  • Knowledge of dental codes and billing practices

  • Dental Assisting or Dental Hygiene experience is an asset

  • University degree or equivalent work experience    

  • 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 communication (both phone and face-to-face) and written communication skills  

  • Intermediate data analysis skills with expertise using Excel and other data mining software 

  • Demonstrated investigation skills with attention to detail  

  • Ability to be creative, critical and aggressive in managing audit and investigative activities

  • Organizational skills and the ability to manage multiple conflicting priorities

  • Bilingual is an asset

What can we offer you?

  • A competitive salary and benefits package.

  • A growth trajectory that extends upward and outward, encouraging you to follow your passions and learn new skills.

  • A focus on growing your career path with us.

  • Flexible work policies and strong work-life balance.

  • Professional development and leadership opportunities.

Our commitment to you

  • Values-first culture: We lead with our Values every day and bring them to life together.

  • Boundless opportunity: We create opportunities to learn and grow at every stage of your career.

  • Boundless opportunity: We invite you to help redefine the future of financial services.

  • Delivering the promise of Diversity, Equity and Inclusion: We foster an inclusive workplace where everyone thrives.

  • Championing Corporate Citizenship: We build a business that benefits all stakeholders and has a positive social and environmental impact.

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About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.

Manulife is an Equal Opportunity Employer

At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact [email protected].

Primary Location

Waterloo, Ontario

Working Arrangement

Hybrid

Salary range is expected to be between

$49,575.00 CAD - $82,625.00 CAD

If you are applying for this role outside of the primary location, please contact [email protected] for the salary range for your location. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance.

Manulife offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in Canada includes holidays, vacation, personal, and sick days, and we offer the full range of statutory leaves of absence. If you are applying for this role in the U.S., please contact [email protected] for more information about U.S.-specific paid time off provisions.