Manager, Travel Claims Vendor Risk & Oversight at Manulife in Waterloo, ON

Job description

Manager, Travel Claims Vendor Risk & Oversight Travel Claims is changing the way it works. Over the next nine months the way a travel claim is received, routed, reviewed and audited is being redesigned and part-automated through our delivery partner, and Travel Claims is one of three areas of the business in scope. At the same time the volume of secondary reviews coming into the team has roughly doubled inside a year. We are looking for a manager who can run a team of experienced claims professionals through that change and come out the other side with a faster process, better decisions and a team working in a genuinely different way. This role leads the Travel Claims Risk Management Team, the group that handles our highest-value, most sensitive and most complex claim decisions. Much of the claim handling behind those decisions sits with a third-party administrator, so a central part of the job is second-line oversight of that vendor: setting the control expectations, testing whether they are being met, and escalating when they are not. The role is also the business owner for the Travel Claims part of the transformation programme and the person who owns what the team's numbers say. It is deliberately built with more scope than the job it replaces, and it is a natural development role for someone ready to grow into a director position. Reports to the Director, Affinity Claims, Canada Segment. Leads a team of eight covering high-risk medical and non-medical claims, denials, appeals, sensitive and escalated files, legal and media threats, regulatory inquiries and large-loss oversight. Works closely with the Audit and Operations team and shares the audit and recovery agenda with it. Represents Travel Claims to our third-party administrator, to the transformation programme and to the Affinity Operations leadership team and works with first- and second-line risk, compliance and vendor management colleagues on the oversight of that administrator. We expect the person in this role to model a different way of working rather than simply manage through the change. That means building your own view of the work instead of requesting a report, testing an idea in a short cycle and showing the result rather than writing a paper about it, making the case for a change in numbers that the team and the executive can both check, using AI as part of everyday work with a clear view of where human judgement stays, and holding a position with a delivery or outsourcing partner when the evidence supports it. Position Responsibilities: · Claim decisions and medical case management oLead the review of high-value and complex travel claims, working within the approval authorities set for the business, and make or endorse the decision on files that carry financial, regulatory or reputational weight. Set the standard for the written reasoning behind a decision, particularly where a review changes an earlier outcome. Manage the flow of work so the oldest and highest-value files are the ones being worked and keep the team's open inventory visible and current. Act as the escalation point for claimant complaints, legal and media threats and regulator enquiries that reach the team. · Audit, quality and recoveries oPartner with the Audit and Operations team on the monthly audit programme covering both Affinity and Group Benefits travel business. Turn audit findings into process change rather than only file correction, feeding themes into training, into the administrator's handling standards and into the automation backlog. Own the connection between what audit identifies and what is actually recovered and establish the recovery baseline the business does not have today. Contribute to annual audit cycles including licensing, case fee and recovery reviews. · Data, reporting and insight oRun the team on evidence. Build and maintain a live view of intake, time waiting before assignment, active review time, open work by age and value, overturn rates and audit findings,