Manager, Investigations

The Canada Life Assurance Company • Toronto, ON

2d • CA$102,000 - CA$152,000 • Hybrid

About The Position

As the Manager Investigations, you will be accountable for a team of investigators responsible for investigation of suspected plan member and provider Group Health & Dental claims fraud, manage key client communications and reporting of investigation and program results and outcomes, and contribute to Canada Life’s overall mitigation of fraud risk for its Group Customers.

Requirements

• Post-secondary education; justice studies or a related field an asset
• Certified Fraud Examiner (CFE) designation an asset
• 3+ years of leadership experience
• Experience in investigations, auditing, fraud examination, or leading investigation teams
• Proven leadership, relationship management, collaboration, critical thinking, problem-solving, and decision-making skills
• Strong interpersonal skills with the ability to build relationships, influence change, negotiate, and collaborate effectively with a broad range of stakeholders
• Excellent written and verbal communication skills, including experience preparing and delivering communications, interacting with clients and internal audiences, and delivering difficult messages when required
• Highly organized with exceptional attention to detail and accuracy; able to manage multiple priorities, adapt to changing demands, and meet deadlines in a fast-paced environment
• Strong analytical abilities with the aptitude to assess, understand, and deliver on complex investigations and reporting requirements
• Advanced proficiency in Microsoft Office applications, including Outlook, Excel, Word, and PowerPoint, with strong working knowledge of Excel
• Reliability Status Security Clearance – this can only be completed with candidates who receive an offer of employment. This is a personal security status that is required as a condition of employment before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada website. The cost of submitting these checks will be covered by Canada Life.

Nice To Haves

• justice studies or a related field an asset
• Certified Fraud Examiner (CFE) designation an asset

Responsibilities

• Cultivate and strengthen relationships with key clients; Understand client needs and partner with other Canada Life operational areas to deliver on objectives
• Represent Canada Life in client meetings acting as a subject matter expert for investigations and client reporting, showcasing results and program activities
• Manage the execution of investigations of suspected external Group Health & Dental claims fraud committed by plan members, providers, and those associated to the provision of healthcare services/supplies, prioritizing investigations against staff resources
• Ensures the team operations deliver on strategic objectives
• Ensure investigations are completed in a timely manner, are high-quality and accurate, and timely and insightful reporting on investigative outcomes is surfaced
• Work with other leaders of the Fraud Management team to innovate and expand the tactics employed to ensure investigations are effective and the team takes creative and evolving approaches in keeping with the changing risk landscape
• Participate in root cause analyses on cases of confirmed fraud, identify and support remediation and corrective action in conjunction with internal stakeholders and partners
• Communicate investigation results to internal stakeholders. Establish and maintain reporting and metrics to permit evaluation of the effectiveness of investigations.
• Participate on fraud risk initiatives, committees, and working groups across the organization and at industry.
• Stay current on industry, fraud, risk, legal and litigation trends
• Provide strong leadership; manage/oversee hiring, performance management, annual salary adjustments, training plans, development, mentoring and coaching of staff.

Benefits

• Career Development: Opportunities for career advancement, access to industry-leading learning programs and up to $2,000 annually towards education reimbursement.
• Health & Wellness: Flexible health and dental benefits, plus a $5,000 mental health benefit to support your well-being.
• Time Off: In addition to regular vacation and personal days, we support community involvement with a volunteer day.
• Financial Security: Company-matching pension plan, share ownership program and additional investment options.
• Rewards and Recognition: Employee recognition programs, service milestone celebrations, employee discounts and more!
• Emphasis on Community: We provide a workplace where employees feel connected and supported through Employee Resource Groups (ERGs), mentorship programs, social clubs and events.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Associate degree