AVP Long Term Care Transformation, Claims Initiation and Management
We are a leading financial services provider committed to making decisions easier and lives better for our customers and colleagues around the world. From our environmental initiatives to our community investments, we lead with values throughout our business. To help us stand out, we help you step up, because when colleagues are healthy, respected and meaningfully challenged, we all thrive. Discover how you can grow your career, make impact and drive real change with our Winning Team today.
John Hancock is a unit of Manulife Financial Corporation, a leading international financial services group offering insurance and wealth management solutions in the US, Canada, Europe, and Asia.
We are on a transformational journey. We want to remove complexity from the financial services industry, to make people’s lives better by helping to make their decisions easier. Being part of this transformation is hugely exciting and offers talented, ambitious people an amazing opportunity to build a career. We value innovation and have a proven track-record, with a unique behavioral insurance offering that rewards customer for living a longer, healthier life.
We are looking for a Transformation Leader with proven business knowledge and experience in implementing anti-fraud capabilities with a primary focus on leading cross-functional squads dedicated to identifying and preventing suspicious fraud activity in our US Long-term Care (LTC) claims process using tools, controls and Machine Learning /AI techniques to drive results. You will partner with all squads in the Value Stream focused on digital customer experiences (e.g., document analytics, customer portal, mobile app development) and will work closely with the actuarial team and fraud case investigative team.
This is a unique opportunity to lead a highly visible strategic initiative with significant revenue potential.
This job description does not represent a comprehensive listing of job duties that are required of the employee performing this role. We reserve the right to change duties or assign additional duties at any time with or without notice.
The LTC Claims Management Leader acts as the voice of the business and voice of the customer for the claims management component of the Long-Term Care policyholder and caregiver experiences with a specific focus on preventing fraud and abuse. This Leader represents the claims management process holistically (from claim initiation to ongoing reimbursement), instituting transformational practices, tools, and artificial intelligence solutions to detect, capture and proactively prevent fraud/abuse within the LTC claims experience while also monitoring analytics and results to further enable practices based on learning.
The Leader delivers business value working in partnership with multiple cross-functional delivery teams and business leaders to ensure holistic products (i.e., organizational business capabilities) are delivered in alignment with business and customer priorities.
The Leader proactively monitors and shares industry, competitive & general business trends within the Fraud space, serving as a thought partner and strategist to internal stakeholders and business leaders across the US, challenging norms and encouraging teams to think differently.
This role contributes to the realization of the Anti-Fraud Waste and Abuse strategy, vision, outcomes, and key results by aligning and prioritizing business goals with actionable results. This individual may have one or more VS Product Owner(s) reporting into this role, responsible for coaching and career development.
- Brings a senior level strategic view and tactical delivery of products, tools, controls, and business processes aligned to the fraud and segment priorities.
- Drives the strategy, planning and delivery of key Fraud capabilities.
- Identifies cross squad dependencies and impediments to achieving outcomes.
- Acts as thought partner to business stakeholders on multi-million-dollar Fraud priorities
The LTC Claims Management Leader’s primary responsibilities can be divided into three categories and is responsible for the claims management journey (from intake to payout) with an emphasis on fraud waste and abuse prevention. This role can also have direct reports and provides management and career development for one or more VS Product Owner(s).
Voice of the Business, Customer, and End-User (in context of direction from the Experience Strategist)
- Responsible for business outcomes in alignment with Fraud/Abuse priorities
- Acts as the voice of the business and voice of the customer within the squads/ART to ensure business and end-user satisfaction.
- Maintains an excellent understanding of business, customer, and end-user pain points, needs, and preferences.
- Maintains an excellent understanding of relevant personas and customer journeys in order to advocate for the ideal experience.
- Proactively monitors and shares industry, competitive and general business trends to enable strategic planning and delivery of outcomes in alignment with segment priorities.
- Works as the “customer proxy” and consistently applies to customer lens to solutions.
- Ensures the voice of the customer/stakeholder is prominent and accurate in the definition of user stories.
- Drives the strategy, planning and delivery of key capabilities for the Fraud business journey, including features.
- Ensures value creation for the business, customers, and end-users by owning the squad backlog and ensuring that the highest value work is always being executed.
- Work with delivery teams to define hypotheses, run experiments (surveys, concept testing, analytics tools, A/B testing), and analyze data to make decisions on user stories that influence the direction of delivery.
- Builds and grooms the user story backlog.
- Ensures the backlog is visible, clear, and understood by all team members.
- Incorporates feedback from stakeholder demos, interviews, user research, and engineering.
- Accepts the work outputs (i.e., completed user stories) of the squad by ensuring all stories meet the definition of done.
Squad Alignment & Communication
- Brings strong coaching mindset to delivery practices.
- Strong leadership capabilities and is a champion of agile practices and product content knowledge; acts as role model.
- Specify and effectively communicate desired outcomes for current and future capabilities.
- Leads or assists in demonstrations of the squad’s outputs (i.e., working software).
- Reviews and contributes to the value stream roadmap.
- Drafts specific objectives and key results (OKRs) in alignment with those of the value stream.
- Proven experience driving transformational outcomes with new/emerging technologies requiring innovation and a test/learn/pivot approach.
- Insurance fraud detection, preferably in long-term care, workers compensation, property & casualty, health, or disability insurance.
- Experience with Long-term Care or Medicare/Medicaid in the US market preferred.
- Team leadership with direct management of Product Owner(s)
- Excellent understanding of flow of work from intake to release with an eye toward optimizing VS work in progress, clearly communicating priorities for upcoming work, and maintaining alignment to value stream level OKRs.
- Ability to gather and interpret data/results to drive learning and evolve practices.
- Excellent coaching mindset and abilities, enabling team members in defining solutions, and delivering to outcomes.
- Engagement of squad members to collaborate, promote ownership and accountability of tasks, and maintain continuous improvement mindset.
- Acts as thought partner to stakeholders with excellent stakeholder management and communication skills in defining outcomes, communicating progress, and facilitating planning.
- Excellent knowledge of the business, with previous, active role as a Product Owner/Manager strongly preferred.
- Previous team management and/or coaching experience preferred.
- Excellent knowledge of digital enterprise enablement technologies and practices.
- Minimum of 10+ years of experience in a business role.
About Manulife and John Hancock
Manulife Financial Corporation is a leading international financial services group that helps people make their decisions easier and lives better. With our global headquarters in Toronto, Canada, we operate as Manulife across our offices in Asia, Canada, and Europe, and primarily as John Hancock in the United States. We provide financial advice, insurance, and wealth and asset management solutions for individuals, groups and institutions. At the end of 2022, we had more than 40,000 employees, over 116,000 agents, and thousands of distribution partners, serving over 34 million customers. At the end of 2022, we had $1.3 trillion (US$1.0 trillion) in assets under management and administration, including total invested assets of $0.4 trillion (US $0.3 trillion), and segregated funds net assets of $0.3 trillion (US$0.3 trillion). We trade as ‘MFC’ on the Toronto, New York, and the Philippine stock exchanges, and under ‘945’ in Hong Kong.
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
Salary & Benefits
The annual base salary for this role is listed below.
Primary LocationBoston, Massachusetts
Salary range is expected to be between$111,900.00 USD - $201,420.00 USD
If you are applying for this role outside of the primary location, please contact firstname.lastname@example.org for the salary range for your location. The actual salary will vary depending on local market conditions, geography and relevant job-related factors such as knowledge, skills, qualifications, experience, and education/training. Employees also have the opportunity to participate in incentive programs and earn incentive compensation tied to business and individual performance.
Manulife/John Hancock offers eligible employees a wide array of customizable benefits, including health, dental, mental health, vision, short- and long-term disability, life and AD&D insurance coverage, adoption/surrogacy and wellness benefits, and employee/family assistance plans. We also offer eligible employees various retirement savings plans (including pension/401(k) savings plans and a global share ownership plan with employer matching contributions) and financial education and counseling resources. Our generous paid time off program in the U.S. includes up to 11 paid holidays, 3 personal days, 150 hours of vacation, and 40 hours of sick time (or more where required by law) each year, and we offer the full range of statutory leaves of absence.