Manager, Fraud Risk Management

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

About the role:

Fraud management is increasingly important to policyholders. To serve Sun Life’s clients as industry leaders, Canadian Operations’ Fraud Risk Management area will identify, mitigate and respond to criminal threats using various tools, technologies and strategies.

This role has a strong leadership and dental knowledge requirement. Reporting to the Director of Fraud Risk Management (FRM), the successful candidate will work closely with contracted Dentists and be accountable for leading a team of dental Investigators, who are responsible for fraud detection, prevention and investigation of dental claims across Canada. The successful candidate will work in partnership with other FRM leaders and teams to ensure the successful delivery of all business objectives. They will contribute to setting and prioritizing operational initiatives, creating new processes, leveraging existing techniques and technologies and developing our people to meet current and future business needs. They will develop business partnerships with areas that support the team and service delivery such as Legal, Compliance, Group Benefits Customer Care Centre, Group Health & Dental Claims and Business Development.

As the sophistication and scope of fraud schemes escalate, the Manager will need to lead change while maintaining the daily operations.

This role is primarily focused on the dental business for the Canadian Dental Care Plan (CDCP) and can be based out of Waterloo, Toronto or Montreal.

What will you do?

• Lead direct reports in executing quality service delivery and support them by providing direction, setting clear expectations, coaching, being available, fostering engagement and holding individuals accountable for results.
• Develop the team’s competencies to fully utilize individual team members’ strengths and talents.
• Apply focus to meeting contractual requirements, and the timely completion of dental audits and investigations.
• Champion a culture of continuous improvement and innovation to deliver on the ever-evolving expectations of our plan members and plan sponsors, and emerging trends related to fraud and abuse matters.
• Collaborate effectively with internal and external stakeholders.
• Monitor emerging trends in dental care to identify potential risk of misuse or abuse of dental claims.
• Participate in speaking engagements, presentations and client meetings.

What do you need to succeed?

• Minimum of two years experience leading a team focused on fraud and abuse management, criminal investigations or equivalency.
• Strong knowledge of dental terminology and expense codes.
• Superior leadership skills, ability to influence solutions and facilitate cross-departmental teamwork that meets the needs of the business strategy.
• Strong analytical skills and critical thinking with attention to accuracy and details.
• Excellent communication skills (written and verbal), interviewing and experience presenting sensitive matters to customers or senior management.
• Superior organizational skills and ability to multi-task, prioritize initiatives and execute effectively.
• As this position is posted in several locations, we specify that bilingualism (French, English, both oral and written) is required for Quebec only as the position includes managing both French and English-speaking staff (Quebec and outside Quebec) and providing daily support to the team.

Preferred Skills:

• Dental industry expertise attained through experience as a dental professional.
• University degree or postsecondary education in a related field.
• Experience working within investigations, audit, or policing.
• Fluency in two or more languages.

Unique Requirements:

• This position can be based in Waterloo, Toronto or Montreal.
• Some travel may be required.
• The candidate selected for this role is required to attain Canadian Reliability Security Clearance (administered by submitting fingerprints to the RCMP, who then conduct min. 5-year history checks)
• To see if you are eligible for this clearance, please review the section 201 on the Federal Government site ( https://www.tpsgc-pwgsc.gc.ca/esc-src/personnel/pdcf-rsrp-eng.html)

What's in it for you?

• Hybrid work environment
• A friendly, collaborative, and inclusive culture
• 20 vacation days per year
• Flexible Benefits from the day you join to meet the needs of you and your family
• Pension, stock and savings programs to help build and enhance your future financial security
• The opportunity to move along a variety of career paths with amazing networking potential
• Access to our Global Learning Centre, available 24/7 for your learning needs
• Wellness programs that support the three pillars of your health – mental, physical and financial

Recent Awards:

• We are honoured to be recognized as a 2022, 2023 and 2024 Best Workplaces in Canada by Great Place to Work® Canada
• Great Place to Work® list for Best Workplaces for #HybridWork 2022
• Great Place to Work® list for Best Workplaces for Professional Development in Canada 2022
• Named “Best Places to Work” by Glassdoor, 2021 and 2023

The Base Pay range is for the primary location for which the job is posted. It may vary depending on the work location of the successful candidate or other factors. In addition to Base Pay, eligible Sun Life employees participate in various incentive plans, payment under which is discretionary and subject to individual and company performance. Certain sales focused roles have sales incentive plans based on individual or group sales results. 

Diversity and inclusion have always been at the core of our values at Sun Life. A diverse workforce with wide perspectives and creative ideas benefits our clients, the communities where we operate and all of us as colleagues. We welcome applications from qualified individuals from all backgrounds.

Persons with disabilities who need accommodation in the application process or those needing job postings in an alternative format may e-mail a request to [email protected].

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

We thank all applicants for showing an interest in this position. Only those selected for an interview will be contacted.

Salary Range:

78,000/78 000 - 128,000/128 000

Job Category:

Risk Management

Posting End Date:

01/12/2024