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Added 20 mins ago
RI
Senior Clinical IAM & RBAC Business Analyst - Healthcare
Rose International
Fredericton, NB
- Full-time
A Bachelor’s level University degree in Computer Science, Business Administration, Health Informatics, or a similar discipline. An equivalent combination of education and experience may be…
Added 50 mins ago
NE
Sales Operations Analyst
Nexus Energy
Toronto, ON
- Contract
Education: Bachelor’s degree or college diploma in Business, Marketing, Engineering, Finance, Mathematics, Data Analytics, or a related field
Added 1 hour ago
LC
Manager, Supply Chain Replenishment
Loblaw Companies Limited
Brampton, ON
- Full-time
Own issue management process for IPFR and SAP with focus on engaging Sr. Analyst to create process improvements to prevent issues
Added 2 hours ago
AA
Project Management Analyst
August Advisors
Toronto, ON · Greater Toronto Area, Canada
- Full-time
August Advisors is a Toronto-based placement business that provides bespoke fundraising solutions to high-quality middle-market global alternative asset managers (General Partners),…
Added 3 hours ago
S
DCN Project Controls System Analyst
SLB
Calgary, AB
- Full-time
The Project Controls System Analyst supports the Project Controls organization by administering, configuring, integrating, and continuously improving the digital toolset and data workflows…
Added 3 hours ago
C
Senior Analyst, Macro Research
CIBC
Toronto, ON
- Full-time
The Senior Analyst plays an important role in shaping CIBC Global Asset Management’s applied macro research and portfolio perspectives. As a core member of the Global Research team, you’ll…
Added 3 hours ago
Y
Business Systems Analyst (Dynamics 365 BC)
Yochana
Mississauga, ON
- Contract
Role: Business Systems Analyst (Dynamics 365 BC) - Hybrid Mississauga
Added 3 hours ago
B
Senior Databricks Data Platform Engineer
Brillio
Canada
- Contract
…This is a platform-first role: rather than building individual business pipelines, you will build the foundation that every data engineer, analyst, and data scientist depends on, including…
Added 3 hours ago
F饭
Marketing Business Systems Analyst
Fantuan 饭团
Toronto, ON
- Full-time
A bachelor’s degree or higher in Business Analytics, Information Systems, Marketing, Computer Science, Data Analytics, or a related field.
Added 4 hours ago
PH
Privacy and Security Analyst, BC Health Workday
Provincial Health Services Authority
BC · British Columbia, Canada
- Full-time
Added 4 hours ago
C
Manufacturing Business Analyst (Cabico Coaticook)
Cabico&co
Coaticook, QC
- Full-time
We are seeking a Business Analyst to join our team at our Coaticook, QC site. Your mission: you will bridge the needs of the business and production teams with our technological solutions.…
Added 4 hours ago
PH
Financial Analyst, Physician Compensation
Provincial Health Services Authority
Vancouver, BC
- Full-time
The Financial Analyst develops and maintains financial models, reports, and data resources used to track physician compensation, funding, recoveries, sessions, salaries, and FTE…
Added 4 hours ago
OP
Senior Analyst, Lease Accounting
Oxford Properties Group
Toronto, ON
- Full-time
The Senior Analyst, Lease Accounting involves reviewing and interpreting lease documents to ensure accurate setup for billing tenants and verifying the accuracy of tenant recoveries during…
Added 4 hours ago
AC
Analyste d’affaires, Marchés des capitaux
Amaris Consulting | Part of Mantu
Toronto, ON
- Full-time
You will be supporting different projects through your expertise as Business Analyst, Capital Markets.
Added 4 hours ago
KP
Project Leader (Systems Analyst) - Competition ID: 4882
Kwantlen Polytechnic University
Surrey, BC
- Full-time
We are currently seeking a Project Leader (Systems Analyst) to join our Office of the Registrar team.
Added 4 hours ago
OM
Analyst, Marketing Science
Omnicom Media
Toronto, ON
- Full-time
As an Analyst, you have a background in data analysis, performance marketing, digital analytics, media planning/strategy, or something along those lines. You are generally what people would…
Added 4 hours ago
FS
Senior Risk Analyst
Financial Services Regulatory Authority of Ontario (FSRA)
Toronto, ON
- Full-time
High level skills in using data analytics and visualization technologies and tools (e.g. Python, MS Excel, MS SQL, MS Access, PowerBI) to manipulate large data sets to analyze, test,…
Added 4 hours ago
C
Supply Chain Data Analyst
Convergint
Calgary, AB
- Full-time
Job Description: Convergint is looking for a team-oriented, results-driven, Supply Chain Data Analyst, to join our amazing culture. As the Supply Chain Data Analyst, you will be responsible…
Added 4 hours ago
E
System Test Analyst
Ericsson
Ottawa, ON
- Full-time
The role of System Test Analyst is located in Ottawa. Ericsson promotes and supports a hybrid workplace environment. This is a full-time, and permanent based position within the Systems,…
Added 4 hours ago
AC
Full-time Institutional Research Advanced Data Analyst
Algonquin College of Applied Arts and Technology
Ottawa, ON
- Full-time
Reporting to the Manager, Institutional Analytics and Planning, the IR Advanced Data Analyst develops predictive models, forecasts and advanced analytical tools to support strategic,…
Added 5 hours ago
T
Senior Finance Analyst
TD
Toronto, ON
- Full-time
$81,600 - $115,200 CADThis role is eligible for a discretionary variable compensation award that considers business and individual performance.
Added 5 hours ago
T
Product Control Analyst
TD
Toronto, ON
- Full-time
…job-related knowledge, geographic location, and other specific business and organizational…
Added 5 hours ago
T
Engineer I
TD
Mississauga, ON · Toronto, ON
- Full-time
Work with the team to plan strategic roadmap for analytics technologies in coordination with the business aspects of security engineering and Cyber Threat Management teams.
Added 5 hours ago
HT
Master Data Mgmt Analyst
Husky Technologies
Bolton, ON
- Full-time
…data records in the appropriate systems in compliance with business policies, documented procedures and data quality…
Added 5 hours ago
VB
Senior FP&A and Systems Analyst (6 Month Contract)
Vaco by Highspring
Toronto, ON · Greater Toronto Area, Canada
- Full-time
Senior FP&A and Systems Analyst – 6 Month Contract

GreenShield

INVESTIGATIVE ANALYST

Windsor, ON, Canada

$59,688 to $91,109 CAD / year · Contract

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Job details

Pay: $59,688 to $91,109 CAD / year
Job type: Contract
Apply by: Dec 4, 2026
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

THE ROLE IN A NUTSHELL

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

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 ARE 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.

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

Lead complex, high-risk investigations and use reporting, AI, and data analysis to identify fraud, abuse, misuse, emerging patterns, and systemic risks. Develop fraud controls and risk-mitigation recommendations, produce executive-level reporting, collaborate with internal and external stakeholders, and mentor investigative staff.

Requirements

Requires at least five years of experience in audit and fraud detection, health care benefit administration, and/or investigations, along with a business-related university degree or college diploma. Candidates should bring strong analytical and communication skills, independent judgment, working knowledge of AI and BI tools, and the ability to mentor others; knowledge of relevant legislation and experience with preventative fraud strategies are assets.

Skills

Fraud Detection
Investigations
Data Analysis
Risk Assessment
AI Technology
Business Intelligence
Data Visualization
Audit
Interviewing
Reporting
Microsoft Excel
Microsoft Access
Mentorship
Stakeholder Communication
Health and Dental Benefits Administration
Privacy and Regulatory Compliance

Visa sponsorship

Not detected in the job text

Keywords

Claim Watch
Fraud Detection
Complex Investigations
High-Risk Investigations
Health Care Benefit Administration
Group Health and Dental
Artificial Intelligence
Reporting
Data Analytics
Utilization Trends
Provider Profiling
Plan Member Profiling
Fraud Controls
Cost Containment
Risk Mitigation
Automation
Intelligent Auditing
Audit
Compliance
Enterprise Risk
Business Intelligence
Data Visualization
Dashboards
Performance Metrics
PIPEDA
Regulated Health Professions Act
Privacy Act
Microsoft Access
Microsoft Excel
Law Enforcement

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