Ltc Fraud Investigator

Manulife Financial Corporation

Massachusetts, US
Base: $73,350.00 - $122,250.00 usd; bonus/equity: ...
Fully remote
3-5 years long-term care experience
Strong analytical and critical-thinking skills
Advanced excel skills with large datasets
This role involves analyzing Long-Term Care claims and provider billing patterns to identify potential fraud, waste, and abuse

Job Summary

  • This role involves analyzing Long-Term Care claims and provider billing patterns to identify potential fraud, waste, and abuse.
  • The position requires leading targeted customer outreach to explain updated claim reimbursement controls and drive compliance.
  • Employees will work in a flexible environment that supports well-being, inclusion, and career growth within a global team.

Matching Summary

This role involves analyzing Long-Term Care claims and provider billing patterns to identify potential fraud, waste, and abuse.

Salary

Base: $73,350.00 - $122,250.00 USD; Bonus/Equity: Incentive compensation tied to performance available; Benefits: Health, dental, vision, 401(k) matching, paid time off

Skills & Requirements

Must-have

  • 3-5 years Long-Term Care experience
  • Strong analytical and critical-thinking skills
  • Advanced Excel skills with large datasets

Nice-to-have

  • Familiarity with SQL SAS or BI tools
  • Experience with Medicaid commercial LTC benefits
  • Clear written and verbal communication

Key Requirements

  • 3–5 years of experience in Long-Term Care or Fraud Waste & Abuse
  • Ability to translate findings into business requirements and user stories
  • Familiarity with fraud investigations SIU and case management tools preferred

Work Rights

Not specified

Tailored Resume

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