Perform risk-based data profiling to identify trends and outliers, leading investigations to successful conclusions, including preparing criminal and regulatory complaints.
Lead and support audit programs by coordinating, assessing, and making decisions on investigations, and conducting interviews with plan members and service providers.
Create written audits and correspondence for plan members and service providers, while engaging with internal and external stakeholders to ensure comprehensive investigation processes.

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
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 or higher 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

health, dental, mental health, vision, short
and long-term disability, life and AD&D insurance coverage
adoption/surrogacy and wellness benefits
employee/family assistance plans
various retirement savings plans (including pension and a global share ownership plan with employer matching contributions)
financial education and counseling resources
generous paid time off program including holidays, vacation, personal, and sick days, and the full range of statutory leaves of absence

Investigation Analyst – Provider Risk

Key skills