Claims Operations and Process Support

• Serve as a subject matter expert for healthcare claims assessment, benefit interpretation, policy provisions, and end-to-end operational workflows.
• Review complex or escalated claims and provide clear guidance to support accurate and consistent decisions.
• Identify recurring issues, control gaps, rework drivers, and opportunities to improve quality, efficiency, and customer outcomes.
• Develop and maintain standard operating procedures, process documentation, and work instructions.
• Support adherence to internal policies, regulatory requirements, audit expectations, service-level agreements, and quality standards.

Project and Business Support

• Represent Claims Operations in system enhancements, healthcare claims projects, and transformation initiatives.
• Support requirements gathering, process mapping, solution walkthroughs, and impact assessments.
• Review business and functional requirements, providing operational input to confirm that claims needs and controls are addressed.
• Collaborate with business stakeholders, IT teams, and vendors throughout design, testing, deployment, and stabilization.
• Support workshops, issue-resolution discussions, deployment readiness, and post-go-live hypercare activities.

User Acceptance Testing and Defect Management

• Prepare, review, and execute end-to-end UAT scenarios and test cases based on business requirements and real claims journeys.
• Validate system functionality, integrations, and auto-adjudication outcomes against expected business results.
• Log clear, reproducible defects in JIRA, attach supporting evidence, track resolution, and complete retesting through closure.
• Coordinate testing activities with business users and project teams to ensure adequate coverage, data readiness, and timely execution.
• Assess test results, open defects, and operational risks to support UAT sign-off and deployment-readiness recommendations.
• Perform post-deployment smoke testing, production validation, and hypercare support as required.

Stakeholder and Vendor Coordination

• Coordinate with Claims Operations, business users, IT teams, and external vendors to resolve issues and deliver agreed outcomes.
• Participate in requirements reviews, defect triage, solution walkthroughs, and operational-readiness discussions.
• Maintain clear action logs, follow up on commitments, and escalate risks or delays in a timely manner.
• Build constructive working relationships across business and technical teams through clear, professional communication.

Required Qualifications

Education

• Bachelor’s degree in Insurance, Business Administration, Healthcare, Information Technology, or a related discipline.

Experience and Skills

• Three to five years of experience in healthcare insurance claims operations, including hands-on claims assessment or administration.
• Sound understanding of healthcare claims workflows, policy provisions, benefit rules, and medical terminology.
• Experience interpreting and validating healthcare claims auto-adjudication (AA) rules, including rule results, approved and disallowed amounts, benefit limits, and expected claim outcomes.
• Hands-on experience in UAT or system-enhancement initiatives, including test-case preparation and execution, evidence capture, defect retesting, and sign-off support.
• Proficiency in JIRA for test execution, defect logging, prioritization, tracking, retesting, evidence management, and closure; experience with JIRA Xray is an advantage.
• Experience working effectively with business users, IT teams, project teams, and external vendors.
• Strong analytical, problem-solving, stakeholder-management, collaboration, and follow-through skills.

Strong spoken and written English communication skills are preferred.

When you join our team:

• We’ll empower you to learn and grow the career you want.
• We’ll 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’ll support you in shaping the future you want to see.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider, helping people make their decisions easier and lives better. To learn more about us, visit https://www.manulife.com/en/about/our-story.html.

Manulife is an Equal Opportunity Employer

At Manulife/John Hancock, we embrace our diversity. We strive to attract, develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment, retention, advancement and compensation, and we administer all of our practices and programs without discrimination on the basis of race, ancestry, place of origin, colour, ethnic origin, citizenship, religion or religious beliefs, creed, sex (including pregnancy and pregnancy-related conditions), sexual orientation, genetic characteristics, veteran status, gender identity, gender expression, age, marital status, family status, disability, or any other ground protected by applicable law.

It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process, contact [email protected].