LTC Fraud Investigator

Time left to apply: End Date: November 9, 2024 (5 days left to apply)Job Requisition ID: JR24100038The Long-Term Care (LTC) business is on a transformational journey. Being part of this transformation is exciting and offers talented, ambitious people an amazing opportunity to build their JH careers.We are looking for a candidate with experience in insurance, Medicare, Long-Term Care or Disability fraud with expertise assessing and investigating suspicious activity/behavior during the claim process.The candidate will be a thought leader identifying and preventing suspicious fraud activity in our US Long-Term Care business using tools, controls, and Machine Learning/AI techniques and solutions to detect, capture, and proactively prevent fraud, waste & abuse within the LTC claims process. You will partner with all squads to drive savings associated with fraud, waste & abuse. The LTC Investigator will conduct desktop investigations of high complexity related to LTC customers on claim. They will assist and support junior investigators on complex cases. The successful candidate will also provide insights to the Data and AI Team on how to evolve data and consider new data sources to drive fraud detection.Individual Responsibilities:Successfully complete investigations with recommendations to internal Global Investigative & Forensic Services team to initiate field investigations and surveillance.Detect, investigate, and prevent fraud, waste & abuse by agents/brokers, customers, providers, POA, and family members.Present case findings to management for review and offer next-step recommendations.Gather and verify information from systems, proprietary databases, and OSINT findings.Obtain and review physical, documentary, and forensic evidence.Produce well-written, accurate, concise, and objective reports.Regularly communicate findings and investigation status.Complete special projects individually or as a part of an FWA team.Maintain knowledge of current investigative techniques, company databases, OSINT, proprietary database resources, and industry trends. Maintain and continuously expand network of professional contacts.Assist in the company fraud awareness training programs and annual department training by contributing to the development of training materials.Perform all duties in strict compliance with department and company guidelines and policies.What are we looking for:Bachelor's degree in criminal justice or related field.Experience in insurance, Medicare, Long-Term Care or Disability fraud.Law enforcement (financial crimes, FBI) background preferred.Five or more years of experience in a related profession.Effective written and verbal communication skills.Proficient in various computer applications (Excel, Access, PowerPoint).Skilled in executing information searches of both the Internet and proprietary databases.Ability to apply a working knowledge of state laws and regulations related to insurance fraud and SIU requirements.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 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.Continuous innovation: 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.Manulife is an Equal Opportunity EmployerAt 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:

Boston, MassachusettsWorking Arrangement:

HybridSalary range is expected to be between:

$68,475.00 USD - $114,125.00 USDIf 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/John Hancock 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/401(k) savings plans and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in the U.S. includes up to 11 paid holidays, 3 personal days, 150 hours of vacation, and 40 hours of sick time (or more where required by law) each year, and we offer the full range of statutory leaves of absence.Know Your Rights:

Family & Medical Leave | Employee Polygraph Protection | Right to Work | E-Verify | Pay TransparencyCompany: John Hancock Life Insurance Company (U.S.A.)About Us

We're Manulife. And we’re on a mission to make decisions easier and lives better.Better is what drives us. It’s what inspires us to find new ways to support customers and colleagues in living longer and healthier lives. It’s the reason we’re dedicated to investing in digital innovation and accelerating a sustainable and economically inclusive future.Joining us means you’ll be empowered to learn and grow your career. We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words. And as part of our global team, you’ll help shape the future you want to see – and discover that better can take you anywhere you want to go.We’re proud of our accomplishments and recognitions. Recent awards include:2024 Gallup Exceptional Workplace Award WinnerManulife Named one of Forbes World’s Best Employers 2023Best Companies to Work for in Asia 2023We’ve been recognized as one of Canada’s Top 100 Employers (2024)Manulife included in Bloomberg’s 2023 Gender-Equality IndexTo receive our latest job opportunities directly to your inbox, create an account or sign in and navigate to the ‘Job Alerts’ section located in the top right corner of the page. From there, you can sign up to receive job alerts.Our ambition is to be the most digital, customer-centric global company in our industry. Learn more at

https://www.manulife.com/ .

#J-18808-Ljbffr