Director, LTC Fraud Strategy & Analytics
Manulife Insurance Malaysia, Boston, Massachusetts, us, 02298
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Date de fin : 13 mars 2026 (Il reste 22 jours pour postuler)job requisition id:
JR26020711The Long-Term Care Anti-Fraud, Waste, and Abuse Analytics Director serve as the voice of business and the customer for the fraud component of Claims focusing specifically on designing and developing controls. Accountable for driving new fraud control development which are integrated though the claims process (initiation through ongoing reimbursement), instituting transformational practices, tools, and AI solutions to prevent and detect controls proactively.This role and the associated squads directed by this role play a critical component in the strategy, vision, outcomes, and key results by aligning and prioritizing business goals with actionable results. With that in mind, Bachelor’s or Master’s degree in Business Administration, Statistics, Mathematics, Data Science, Actuarial Science, or a related field is required.
Candidates with other educational backgrounds may also be considered if they demonstrate strong business acumen in these areas. Equivalent combinations of education and experience will be considered for applicants with relevant, domain‑specific expertise.The candidate will bring a senior-level strategic view and tactical delivery of products, tools, controls, and business processes aligned to fraud prevention and detection. The candidate is accountable for ideating and prioritizing the work across the Analytics and IT squads to design, test and execute data-driven strategies.The ideal candidate will bring:**Strategic Vision:** Ability to connect the dots across multiple functional areas, anticipate capacity needs, and align team efforts with outcomes.**Operational Excellence**: Proven ability to optimize processes, manage resources, and drive efficiency across complex workflows.**Analytical Acumen:** Strong analytical thinking with the ability to interpret data, identify trends, and translate insights into actionable controls.**AI & Data Science Fluency:** Familiarity with emerging technologies, including artificial intelligence, machine learning, and data science methodologies to inform decision-making and innovation.**Project Management Expertise:** Demonstrated success in leading cross-functional initiatives, managing timelines, budgets, and stakeholder expectations.**Leadership:** Energize and elevate the team and foster a culture of engagement and accountability. This individual should be able to prioritize the most valuable work and drive results. The ideal candidate will inspire trust, align the team around shared goals, and cultivate an environment where people feel valued, motivated, and empowered to contribute their best.**Executional Discipline:** Maintain and update key planning tools weekly such as roadmaps, JIRA boards, and status trackers, sponsor decks to ensure transparency, accountability, and momentum across teams.**Position Responsibilities:*** Drives the strategy, planning, prioritization, roadmap, and delivery of key Fraud capabilities with business partners.* Acts as a thought partner to business stakeholders on multi-million-dollar Fraud priorities.* Provide expert insights and recommendations to support strategic decision-making and risk management.* Stay updated on industry trends, emerging fraud schemes, and advancements in fraud detection technologies.* Collaborate with AI to design and develop predictive models to identify potential fraud.* Analyze large datasets to uncover patterns, anomalies, and trends indicative of fraudulent activities.* Identify cross-squad dependencies and impediments to achieving outcomes.* Collaborate with cross-functional teams, including data scientists, claims specialists, Call Center, and IT, to integrate fraud detection models into existing systems.* Collaborate with technical partners to monitor and evaluate model performance ensuring ongoing adjustments to improve detection rates and reduce false positives.* Mentor and guide junior team members, fostering a collaborative and innovative work environment.**Required Qualifications:*** Bachelor’s or Master’s degree in Business Administration, Statistics, Mathematics, Data Science, Actuarial Science, or a related field. Candidates with other educational backgrounds may also be considered if they demonstrate strong business acumen in these areas. Equivalent combinations of education and experience will be considered for applicants with relevant, domain‑specific expertise* Minimum of 6 years of experience in the above-related field with a focus on long-term care insurance. Fraud prevention and detection preferred.* Strong proficiency in statistical software and programming languages such as R, Python, or SAS.* Experience with data visualization tools and techniques.* Excellent analytical, problem-solving, and communication skills.* Proven ability to lead projects and work collaboratively across departments.**When you join our team:*** We will empower you to learn and grow the career you want.* We will recognize and support you in a flexible environment where well-being and inclusion are more than just words.* As part of our global team, we will support you in shaping the future you want to see.**À propos de Manuvie et de John Hancock**La Société Financière Manuvie est un chef de file mondial des services financiers qui aide les gens à prendre leurs décisions plus facilement et à vivre mieux. Pour en apprendre plus à notre sujet, rendez vous à l’adresse .**Manuvie est un employeur qui souscrit au principe de l’égalité d’accès à l’emploi**Chez Manulife/John Hancock nous valorisons notre diversité. Nous nous efforçons d’attirer, de perfectionner et de maintenir une main d'oeuvre qui est aussi diversifiée que nos clients, et de favoriser la création d’un milieu de travail inclusif qui met à profit la diversité de nos employés et les compétences de chacun. Nous nous engageons à assurer un recrutement, une fidélisation, une promotion et une rémunération équitables, et nous administrons toutes nos pratiques et tous nos programmes sans discrimination en raison de la race, de l’ascendance, du lieu d’origine, de la couleur, de l’origine ethnique, de la citoyenneté, de la religion ou des croyances ou des convictions religieuses, du genre (y compris grossesse et affection liée à une grossesse), de l’orientation sexuelle, des caractéristiques génétiques, du statut d’ancien combattant, de l’identité de genre, de l’expression de genre, de l’âge, de l’état matrimonial, de la situation de famille, d’une invalidité ou de tout autre motif protégé par la loi applicable.Nous nous sommes donné comme priorité d’éliminer les obstacles à l’accès égalitaire à l’emploi. C’est pourquoi un représentant des Ressources humaines collaborera avec les candidats qui demandent accommodement raisonnable pendant le recrutement. Tous les renseignements communiqués pendant le processus de demande d'accommodement seront stockés et utilisés conformément aux lois et aux politiques applicables de Manuvie. Pour demander une mesure d’accommodement raisonnable dans le cadre du recrutement, écrivez à recruitment@manulife.com.**Referenced Salary Location**Boston, Massachusetts**Modalités de travail**Hybride**Salary range is expected to be between**$128,550.00 USD - $222,820.00 USDSi vous posez votre candidature à ce poste en dehors de la région principale, veuillez #J-18808-Ljbffr
*pour fournir des statistiques qui nous aident à vous offrir la meilleure expérience sur note site. Vous y trouverez des renseignements sur les témoins, ou vous pouvez les désactiver si vous préférez. Toutefois, en continuant d’utiliser le site sans modifier les paramètres, vous consentez à notre utilisation de***Director, LTC Fraud Strategy & Analytics page is loaded## Director, LTC Fraud Strategy & Analyticslocations:
Boston, Massachusettstime type:
Temps pleinposted on:
Publié aujourd'huitime left to apply:
Date de fin : 13 mars 2026 (Il reste 22 jours pour postuler)job requisition id:
JR26020711The Long-Term Care Anti-Fraud, Waste, and Abuse Analytics Director serve as the voice of business and the customer for the fraud component of Claims focusing specifically on designing and developing controls. Accountable for driving new fraud control development which are integrated though the claims process (initiation through ongoing reimbursement), instituting transformational practices, tools, and AI solutions to prevent and detect controls proactively.This role and the associated squads directed by this role play a critical component in the strategy, vision, outcomes, and key results by aligning and prioritizing business goals with actionable results. With that in mind, Bachelor’s or Master’s degree in Business Administration, Statistics, Mathematics, Data Science, Actuarial Science, or a related field is required.
Candidates with other educational backgrounds may also be considered if they demonstrate strong business acumen in these areas. Equivalent combinations of education and experience will be considered for applicants with relevant, domain‑specific expertise.The candidate will bring a senior-level strategic view and tactical delivery of products, tools, controls, and business processes aligned to fraud prevention and detection. The candidate is accountable for ideating and prioritizing the work across the Analytics and IT squads to design, test and execute data-driven strategies.The ideal candidate will bring:**Strategic Vision:** Ability to connect the dots across multiple functional areas, anticipate capacity needs, and align team efforts with outcomes.**Operational Excellence**: Proven ability to optimize processes, manage resources, and drive efficiency across complex workflows.**Analytical Acumen:** Strong analytical thinking with the ability to interpret data, identify trends, and translate insights into actionable controls.**AI & Data Science Fluency:** Familiarity with emerging technologies, including artificial intelligence, machine learning, and data science methodologies to inform decision-making and innovation.**Project Management Expertise:** Demonstrated success in leading cross-functional initiatives, managing timelines, budgets, and stakeholder expectations.**Leadership:** Energize and elevate the team and foster a culture of engagement and accountability. This individual should be able to prioritize the most valuable work and drive results. The ideal candidate will inspire trust, align the team around shared goals, and cultivate an environment where people feel valued, motivated, and empowered to contribute their best.**Executional Discipline:** Maintain and update key planning tools weekly such as roadmaps, JIRA boards, and status trackers, sponsor decks to ensure transparency, accountability, and momentum across teams.**Position Responsibilities:*** Drives the strategy, planning, prioritization, roadmap, and delivery of key Fraud capabilities with business partners.* Acts as a thought partner to business stakeholders on multi-million-dollar Fraud priorities.* Provide expert insights and recommendations to support strategic decision-making and risk management.* Stay updated on industry trends, emerging fraud schemes, and advancements in fraud detection technologies.* Collaborate with AI to design and develop predictive models to identify potential fraud.* Analyze large datasets to uncover patterns, anomalies, and trends indicative of fraudulent activities.* Identify cross-squad dependencies and impediments to achieving outcomes.* Collaborate with cross-functional teams, including data scientists, claims specialists, Call Center, and IT, to integrate fraud detection models into existing systems.* Collaborate with technical partners to monitor and evaluate model performance ensuring ongoing adjustments to improve detection rates and reduce false positives.* Mentor and guide junior team members, fostering a collaborative and innovative work environment.**Required Qualifications:*** Bachelor’s or Master’s degree in Business Administration, Statistics, Mathematics, Data Science, Actuarial Science, or a related field. Candidates with other educational backgrounds may also be considered if they demonstrate strong business acumen in these areas. Equivalent combinations of education and experience will be considered for applicants with relevant, domain‑specific expertise* Minimum of 6 years of experience in the above-related field with a focus on long-term care insurance. Fraud prevention and detection preferred.* Strong proficiency in statistical software and programming languages such as R, Python, or SAS.* Experience with data visualization tools and techniques.* Excellent analytical, problem-solving, and communication skills.* Proven ability to lead projects and work collaboratively across departments.**When you join our team:*** We will empower you to learn and grow the career you want.* We will recognize and support you in a flexible environment where well-being and inclusion are more than just words.* As part of our global team, we will support you in shaping the future you want to see.**À propos de Manuvie et de John Hancock**La Société Financière Manuvie est un chef de file mondial des services financiers qui aide les gens à prendre leurs décisions plus facilement et à vivre mieux. Pour en apprendre plus à notre sujet, rendez vous à l’adresse .**Manuvie est un employeur qui souscrit au principe de l’égalité d’accès à l’emploi**Chez Manulife/John Hancock nous valorisons notre diversité. Nous nous efforçons d’attirer, de perfectionner et de maintenir une main d'oeuvre qui est aussi diversifiée que nos clients, et de favoriser la création d’un milieu de travail inclusif qui met à profit la diversité de nos employés et les compétences de chacun. Nous nous engageons à assurer un recrutement, une fidélisation, une promotion et une rémunération équitables, et nous administrons toutes nos pratiques et tous nos programmes sans discrimination en raison de la race, de l’ascendance, du lieu d’origine, de la couleur, de l’origine ethnique, de la citoyenneté, de la religion ou des croyances ou des convictions religieuses, du genre (y compris grossesse et affection liée à une grossesse), de l’orientation sexuelle, des caractéristiques génétiques, du statut d’ancien combattant, de l’identité de genre, de l’expression de genre, de l’âge, de l’état matrimonial, de la situation de famille, d’une invalidité ou de tout autre motif protégé par la loi applicable.Nous nous sommes donné comme priorité d’éliminer les obstacles à l’accès égalitaire à l’emploi. C’est pourquoi un représentant des Ressources humaines collaborera avec les candidats qui demandent accommodement raisonnable pendant le recrutement. Tous les renseignements communiqués pendant le processus de demande d'accommodement seront stockés et utilisés conformément aux lois et aux politiques applicables de Manuvie. Pour demander une mesure d’accommodement raisonnable dans le cadre du recrutement, écrivez à recruitment@manulife.com.**Referenced Salary Location**Boston, Massachusetts**Modalités de travail**Hybride**Salary range is expected to be between**$128,550.00 USD - $222,820.00 USDSi vous posez votre candidature à ce poste en dehors de la région principale, veuillez #J-18808-Ljbffr