Investigation Analyst (Dental)

Investigation Analyst (Dental)

Apply locations: Waterloo, Ontario; Toronto, Ontario; Halifax, Nova Scotia

Time type: Full time

Posted on: Posted 2 Days Ago

Time left to apply: End Date: January 31, 2025 (12 days left to apply)

Job requisition id: JR25010175

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 the Dental Abuse Management and Investigation Team.

Position 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.

Required Qualifications:

• Knowledge of Group Benefits.
• Knowledge of the Canadian healthcare environment, service delivery model and regulation.
• Knowledge of dental codes and billing practices.
• 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.

Preferred Qualifications:

• Dental Assisting or Dental Hygiene experience is an asset.
• Bilingualism in French is an asset.

When you join our team:

• We’ll empower you to learn and grow the career you want.
• We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words.
• As part of our global team, we’ll support you in shaping the future you want to see.

#LI-Hybrid

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 recruitment@manulife.com.

Primary Location: Waterloo, Ontario

Working Arrangement: Hybrid

Salary range is expected to be between: $42,825.00 CAD - $71,375.00 CAD

If you are applying for this role outside of the primary location, please contact recruitment@manulife.com 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.