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Added 9 mins ago
B
Client Service Associate
BMO
Calgary, AB · CALG
- Full-time
Supports one or more Investment Advisors (IAs) and IA Team and staff, and branch operations with day-to-day administration and provides exceptional client service to support achievement of…
Added 9 mins ago
C
Full-Time Pharmacy Technician
Co-op
Battleford, SK
- Full-time
Co-op is a different kind of business; being member-owned means that any profits are returned to our members and stay in the local economy. If you are a member, then you’re an owner.
Added 9 mins ago
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Nurse A - Registered Nurse Registered Psych Nurse
HealthCareersInSask.ca
Prince Albert, SK
- Part-time
…accordance with the vision, mission and philosophy of the SHA. As a member of the Victoria Hospital nursing department, the Registered Nurse A has the responsibility for the assessment,…
Added 9 mins ago
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Nurse B - Registered Nurse
HealthCareersInSask.ca
Kamsack, SK
- Full-time
Job Description: Reporting to the Primary Health Care (PHC) Manager, the Primary Health Care (PHC) Nurse is an integral member of the PHC team, providing and coordinating initial,…
Added 9 mins ago
Retail Staff
Campari Group
Grimsby, ON · West Grimsby, ON
General Description of the Role: The Retail Staff member is responsible for representing the company in a professional and knowledgeable manner, while delivering exceptional customer…
Added 9 mins ago
WI
Senior Project Manager, Municipal Engineering
WSP in Canada
Fort McMurray, AB
- Full-time
As a key member of the Fort McMurray team, you will contribute to the continued growth of WSP’s municipal practice, support regional pursuits, and collaborate with clients, regulators, and…
Added 9 mins ago
TU
Indigenous Student Development Coordinator
The University of British Columbia
Vancouver, BC
- $7,158.42 to $10,292.25 CAD / month
- Full-time
The incumbent collaborates with faculty, staff, Student Services, the First Nations House of Learning, the Office of Indigenous Strategic Initiatives, Enrolment Services, Indigenous student…
Added 9 mins ago
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Cost Control Manager
FCC Construcción
Toronto, ON
- Full-time
At FCC Canada, you're more than an employee, you're a valued member of a team building infrastructure that connects communities and creates a lasting impact. We foster a collaborative…
Added 9 mins ago
CO
Fitness Specialist
City of Markham
Markham, ON
- Part-time
…for providing members and guests comprehensive guidance and support to ensure achievement of personal fitness goals. The position is also responsible for on-site supervision of patrons of…
Added 9 mins ago
Unit Assistant - Outpatient
Winnipeg Regional Health Authority
Selkirk, MB
Position Summary: As a member of the health care team, the Unit Assistant performs duties related to patient/ client care in accordance with established polices. The Unit Assistant must be…
Added 9 mins ago
BE
Contract Registered Early Childhood Educator (RECE) - Preschool
BrightPath Early Learning & Child Care
Toronto, ON · Etobicoke
- Full-time
Build your career in the early childhood education field and become a valued member of our team at BrightPath Kids! As a proud member of the Busy Bees global childcare community, we offer…
Added 9 mins ago
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Operations Engineer
Canadian Energy Insight Inc.
Calgary, AB
- Full-time
Work with field staff and provide support on a day to day as issues may arise.
Added 9 mins ago
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Visual Merchandiser - Full Time
MEC
Nanaimo, BC
- $20.4 to $23 CAD / hour
- Full-time
…drives us to do good for the planet. We are here to inspire and support everyone in getting active outside, matching people with gear and advice that instills confidence. We offer more than…
Added 25 mins ago
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Personal Banker Trainee
TD
Mississauga, ON
- Full-time
…products and services to refer customers to the appropriate team member or internal Bank partner, while ensuring a positive customer…
Added 25 mins ago
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Manager, Customer Experience Trainee
TD
Calgary, AB
- Full-time
· Support the frontline staff in resolving complaints as per customer problem resolution guidelines; encourage senior team members to act as a point of escalation and take personal…
Added 25 mins ago
HR
Registered Nurse, Cardiology Clinic
Humber River Health
Toronto, ON · Greater Toronto, ON
- Other
At Humber River Health, our staff, physicians, and volunteers are delivering Tomorrow's Healthcare, Today. We are proud to have been recognized as a part of Greater Toronto’s Top Employers…
Added 39 mins ago
Front Line Leader - Finished Products
Global Cellulose Fibers
Grande Prairie, AB
…safely and efficiently utilizing operations, maintenance and support resources to maximize the performance of the Wet End, Dry End, Warehouse, Rail Yard and Shipping and Traffic areas. The…
Added 40 mins ago
RM
Supervisor, Centralized Scheduling
Ross Memorial Hospital
Kawartha Lakes, ON · Lindsay, ON
- Full-time
As a key member of the Human Resources team, you will provide operational leadership, technical expertise, and support to scheduling staff, managers, and directors across the Hospital. You…
Added 40 mins ago
RM
Environmental Services II
Ross Memorial Hospital
Kawartha Lakes, ON · Lindsay, ON
- Full-time
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Added 40 mins ago
RM
M.L.T. Charge - Quality
Ross Memorial Hospital
Kawartha Lakes, ON · Lindsay, ON
- Full-time
Demonstrated leadership ability with the capacity to provide support and guidance to staff.
Added 40 mins ago
RM
Manager - Diagnostic Imaging
Ross Memorial Hospital
Kawartha Lakes, ON · Lindsay, ON
- Full-time
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Added 40 mins ago
RM
Manager
Ross Memorial Hospital
Kawartha Lakes, ON · Lindsay, ON
- Full-time
To display this page you need a browser with JavaScript support.
Added 40 mins ago
SC
Site Manager - $70K - $75K
Securitas Canada
Gatineau, QC
- Full-time
…Operations Center (SOC), providing leadership, direction, and support to security personnel while ensuring the delivery of exceptional security services. The successful candidate will be…
Added 40 mins ago
SC
Site Manager - $70K - $75K
Securitas Canada
Ottawa, ON
- Full-time
…Operations Center (SOC), providing leadership, direction, and support to security personnel while ensuring the delivery of exceptional security services. The successful candidate will be…
Added 40 mins ago
TS
Christmas Kettle Driver
The Salvation Army in Canada
Hamilton, ON
- Part-time
…necessities such as food, clothing and shelter. In addition, we support people experiencing unemployment, addiction and family challenges. We continually adapt and innovate to meet emerging…

Green Shield Canada

INVESTIGATIVE ANALYST (CONTRACT)

Calgary, AB, Canada
Toronto, ON, Canada
Windsor, ON, Canada

Base Salary: CAD $59,688.00 - 91,109.00

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Job details

Pay: Base Salary: CAD $59,688.00 - 91,109.00
Experience: Minimum of 5 years’ experience in audit and fraud detection, health care benefit administration and/or in conducting investigations.
Posting language: English
Posted: Nov 4, 2026

Original job description

WHO WE ARE

GreenShield is a proudly Canadian, national non-profit health care and insurance organization, driven by our mission of Better Health for All. We believe health care is a right, not a privilege, and we are committed to improving health outcomes, advancing health equity, and building a future where every Canadian can reach their full health and well-being potential.

Through our unique integrated payer-provider ("payvider") model, we offer insurance, administer benefits, and pay claims as a ‘payer’ while offering health care services such as mental health, pharmacy, telemedicine, and chronic disease management as a ‘provider’. As a non-profit social enterprise without shareholders, we reinvest our excess earnings to directly support underserved communities. Through GreenShield Cares, we positively impacted the health and well-being of over one million Canadians between 2020 and 2025. What’s driving us now is the commitment to measurably impact an additional three million Canadians by 2030 – across mental health, essential medicines, and chronic disease management – through scalable initiatives that deliver meaningful change in pursuit of our mission of Better Health for All.

At GreenShield, our culture is where purpose meets passion and performance. Our teams work as one to deliver meaningful, measurable impact for the people and communities we serve.

THE ROLE IN A NUTSHELL

Investigation and Analysis

Support the delivery and evolution of the Claim Watch program, including identification and leading of complex and high‑risk investigations.
Leverage reporting and AI technology to identify, research, and analyze abuse, misuse, and fraudulent claims activity with a focus on emerging patterns and systemic risk.
Conduct complex interviews with providers and plan members and exercise independent judgment in ambiguous or precedent‑setting situations.
Analyze utilization trends and develop provider and plan member profiling criteria to support preventative and detective fraud controls, using reporting and AI tooling.
Identify and recommend cost‑containment and risk‑mitigation opportunities, including automation and control enhancements.
Develop and implement preventative fraud measures and support audit, compliance, and enterprise risk activities.
Collaborate across departments and with external stakeholders, including providers, associations, and law enforcement.
Produce executive-level reporting and analytics that translate complex investigative findings, emerging risks, and fraud trends into actionable business insights and strategic recommendations for leadership and clients.
Provide mentorship and guidance to investigative staff and contribute to continuous improvement of investigative practices.
Contribute to and analyze the development of investigative reporting requirements, dashboards, and performance metrics, identifying opportunities to improve visibility into fraud, abuse, misuse, operational effectiveness, and emerging risks.
Provide training and mentoring to peers and team members.
Support the client/partner specific Claim Watch governance framework.

WHO WE'RE LOOKING FOR

Minimum of 5 years’ experience in audit and fraud detection, health care benefit administration and/or in conducting investigations.
Demonstrated ability to exercise independent judgment and make defensible decisions in complex investigative scenarios.
Working knowledge with AI technology.
Exceptional analytical and critical-thinking skills with demonstrated ability to synthesize large and complex data sets, identify emerging patterns, assess risk, and translate findings into strategic recommendations.
Experience contributing to preventative fraud strategies, automation, or intelligent audit approaches (asset).
Demonstrated leadership, mentorship, and ability to influence outcomes across teams without direct authority.
Demonstrated commitment to continuous learning and professional development, with a strong curiosity for emerging technologies, fraud schemes, industry trends, data analytics, and investigative methodologies.
University degree or college diploma in business or related discipline required.
Strong interpersonal skills and the ability to communicate to all levels of internal and external customers both orally and written.
Understanding of group Health & Dental administration.
Excellent customer service with a drive to deliver exceptional service.
Demonstrated capability to meet objectives and milestones when working independently and on project teams.
Highly organized and able to balance multiple tasks in a fast-paced environment.
Working knowledge of relevant federal and provincial legislation, regulations and the judiciary system (Including but not limited to: PIPEDA, Regulated Health Professions Act, Privacy Act) would be an asset.
Proficiency with Microsoft Office tools, including Access, Excel, Word, and other business applications and reporting tools.
Experience using Business Intelligence (BI) and Data Visualization platforms.
Ability to travel within Canada.

WHAT WE OFFER

Base Salary: CAD $59,688.00 - 91,109.00

Offer positioning: Determined using relevant experience, skills, internal equity and current market data.
Total rewards: Health and dental coverage, retirement savings, paid time off and well-being support (up to $10,000 per year for mental health).
Posting disclosures: This is for an existing vacancy.
Work model: Hybrid

THE CULTURE
We believe a career should be meaningful. Not just a means to earn a living. Our culture is one where everyone's voice is heard and valued. Because that’s what it takes to create better health for all. We dare to challenge the status quo. And we’re driven by people who have challenged theirs. We believe that your workplace should empower you to be the best version of yourself. That’s why we provide a place where you can be inspired, challenged, and rewarded.

Where your growth means our growth.
Where your voice is heard and valued.
Where your work has purpose. And purpose matters.

We believe our people are critical to our overall success. Inclusivity makes us a stronger, smarter and more informed organization. Being intentionally inclusive of diverse backgrounds, perspectives and experiences will enhance our company culture to positively impact how we support our communities. A career at GreenShield isn’t just about personal achievements, it's about making a difference together.

Here’s to Better Health for All!

A FEW MORE DETAILS
Proficiency in English is required for this position. As part of this role, you will be required to communicate with colleagues or customers who use English as their primary language. By requiring English proficiency for this position, we aim to ensure that our employees can excel in their roles, collaborate, and communicate effectively, and contribute to the success of our organization.

GS supports diversity, equity and inclusion in our teams and communities, and we value the unique contributions made by all. Even if your experience doesn’t align perfectly to every requirement, we invite you to apply. We encourage applications from all candidates and will accommodate needs under human rights legislation throughout all stages of the recruitment and selection process. Please let us know of any accommodation through requestforaccommodation@greenshield.ca. Information received relating to accommodation will be addressed confidentially.

Providing this information gives GS consent to use your personal information to assess your suitability for specific positions, future opportunities or for your personnel file. Your résumé will be held in strict confidence and will be viewed only by the Organization. Information may be stored outside of Canada and could be used for aggregate statistical purposes (which uses no personal identification).

AI Usage - GreenShield leverages AI to help produce Job Descriptions, and ideate on interview questions. We also leverage AI for interview transcription support.

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More about this job

Responsibilities

The analyst will lead complex investigations into fraudulent claims using AI and reporting tools to identify systemic risks. They will also collaborate with stakeholders to develop preventative fraud measures and provide executive-level reporting on investigative findings.

Requirements

Candidates must have at least 5 years of experience in audit, fraud detection, or health care benefit administration. A university degree or college diploma in business or a related discipline is required, along with proficiency in data analysis and investigative methodologies.

Skills

Fraud detection
Audit
Data analysis
Investigative techniques
AI technology
Critical thinking
Reporting
Risk mitigation
Communication
Mentorship
Business intelligence
Data visualization
Health insurance administration
Project management
Compliance

Benefits

Health coverage
Dental coverage
Retirement savings
Paid time off
Well-being support

Visa sponsorship

Not detected in the job text

Keywords

Fraud detection
Audit
Health care
Insurance
AI
Data analytics
Claim Watch
Risk mitigation
Compliance
Business intelligence
Data visualization
Microsoft Office
Excel
Access
PIPEDA
Privacy Act
Regulated Health Professions Act
Investigation
Reporting
Strategic recommendations
Cost-containment
Mentorship
Non-profit
Health equity
Payvider model

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