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Added 1 hour ago
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Associate - Economic Substance
Waystone
Waterloo, ON
- Full-time
Waystone is a leading asset-servicing solutions provider of institutional governance, administration, risk and compliance services to financial institutions. With over 25 years’ experience…
Added 3 hours ago
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Senior Analyst, Balance Sheet Strategy (12 Month Term)
ATB
Calgary, AB · Edmonton, AB
- Full-time
As ATB’s next Senior Analyst, Balance Sheet Strategy, you will empower the Treasury Balance Sheet Strategy function by transforming complex data into actionable insights that drive key…
Added 5 hours ago
HT
Master Data Mgmt Analyst
Husky Technologies
Bolton, ON
- Full-time
…updating master data records in the appropriate systems in compliance with business policies, documented procedures and data quality…
Added 5 hours ago
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Lead Financial Analyst, FP&A
OpenText
Mississauga, ON
- Full-time
Added 5 hours ago
CB
Senior Information Security, GRC Analyst
Cassels Brock & Blackwell LLP
Toronto, ON
- Full-time
Senior Information Security, GRC Analyst: Toronto. Full Time (Hybrid).
Added 8 hours ago
RC
Equity Research Associate - Energy
Roth Capital Partners
AB
- Full-time
Roth Canada is seeking a motivated, detail-oriented Equity Research Associate to support a Senior Energy Research Analyst covering Canadian oil and gas producers. This opportunity combines…
Added 8 hours ago
D
Senior Financial Analyst
DCM
Brampton, ON
- $80,133 to $100,166 CAD / year
- Full-time
As a Senior Financial Analyst, you will be the primary finance business partner for the Brampton facility, providing timely financial insight, analysis, and decision support to plant…
Added 8 hours ago
RB
Risk Analyst, Third Party Disaster Readiness
Royal Bank of Canada
Toronto, ON
- Full-time
Assists in implementing KRIs/ KPIs/ EXI metrics for our overall compliance reporting obligations.
Added 9 hours ago
Finance Analyst
Kiewit
Oakville, ON
As a Finance Analyst, you will support multiple projects in accounting and finance-related functions.
Added 9 hours ago
AG
Sr. Analyst, Growth & Innovation Operations
Altus Group
Toronto, ON
- Full-time
Reporting to the Director, Growth & Innovation Operations, we are hiring a Senior Analyst, Growth & Innovation Operations to strengthen commercial insights and help turn growth, innovation,…
Added 9 hours ago
QH
Unit Communications Clerk (UCC) / Material Analyst- Belleville Operating Room
Quinte Health
Belleville, ON
- Full-time
The Unit Communications & Clerical Clerk / Material Analyst plays a vital role in supporting clinical teams and ensuring the smooth operation of the Operating Room, Post Anaesthetic Care…
Added 9 hours ago
NS
IMIT Business Analyst - Registration, Switchboard & Data Quality
Nova Scotia Health Authority
NS · Nova Scotia, Canada
- Full-time
Reporting to the IM/IT Business Program Manager, Registration, Switchboard & Data Quality, the IM/IT Business Analyst will be committed to a high standard of performance and is responsible…
Added 10 hours ago
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Senior Business immigration Analyst
Fragomen
ON · Ontario, Canada
- Full-time
About the Role: Fragomen’s Senior Business Immigration Analyst position will provide you with the opportunity to make an immediate impact on our business, as well as offer training,…
Added 10 hours ago
RC
Equity Research Associate - Energy
Roth Canada
AB · Alberta, Canada
- Full-time
Roth Canada is seeking a motivated, detail-oriented Equity Research Associate to support a Senior Energy Research Analyst covering Canadian oil and gas producers. This opportunity combines…
Added 10 hours ago
WC
Senior Analyst, Specialty Compliance and Ethics
Walmart Canada
Mississauga, ON
- Full-time
Maintains and promotes the highest standards of integrity, ethics and compliance; models the Walmart values and leads by example to foster our culture; supports Walmart’s goal of becoming a…
Added 10 hours ago
AS
Business Data Analyst
Apex Systems
Toronto, ON
- $65 to $70 CAD / hour
- Contract
Apex Systems is seeking a Business Data Analyst to join a leading financial services organization in Toronto. This role sits within a business process analytics team in a banking line of…
Added 10 hours ago
PB
Risk & Compliance Analyst / Auditor
Pacific Blue Cross
Burnaby, BC
- Full-time
We're looking for an experienced Risk & Compliance Analyst / Auditor who can help us strengthen how we identify, assess, and manage risk across Pacific Blue Cross.
Added 10 hours ago
AF
Senior Analyst, Balance Sheet Strategy (12 Month Term)
ATB Financial
AB · Edmonton, AB
- Full-time
As ATB’s next Senior Analyst, Balance Sheet Strategy, you will empower the Treasury Balance Sheet Strategy function by transforming complex data into actionable insights that drive key…
Added 10 hours ago
MP
Equity Research Associate - Energy
MKM Partners
Alberta Beach, AB
- Full-time
Roth Canada is seeking a motivated, detail-oriented Equity Research Associate to support a Senior Energy Research Analyst covering Canadian oil and gas producers. This opportunity combines…
Added 11 hours ago
AC
Marketing Manager - Cargo
Air Canada
Toronto, ON · Dorval, QC
- Full-time
Oversee Air Canada Cargo’s branded merchandise and promotional materials, including sourcing, vendors, inventory, budgets, distribution, and brand compliance.
Added 11 hours ago
AI
Data Business Analyst - PL/SQL, T-SQL & Data Warehousing
Astra-North Infoteck Inc. ~ Conquering today’s challenges, achieving tomorrow’s vision!
Toronto, ON
- Full-time
The business team is responsible for the creation of the L2 Model, supported by the Project Business Analyst, Solution Architect, and TSBI.
Added 11 hours ago
C
Fullstack Integration Developer Vice President
Citi
Mississauga, ON
- Full-time
The Applications Development Technology Lead Analyst is a senior-level role responsible for leading the design, implementation, and enhancement of application systems and programs. This…
Added 11 hours ago
C(
Compliance Analyst
Clarity (formerly Hiive)
Vancouver, BC
- Full-time
As a Compliance Analyst at Clarity, you will support the day-to-day work that keeps our broker-dealer and investment adviser compliant. You will start with defined, process-driven tasks and…
Added 11 hours ago
BI
Bilingual BMO Insurance Service Centre Analyst
BMO Insurance
Toronto, ON
- Full-time
The Bilingual BMO Insurance Service Center (BISC) Analyst will play a key role in supporting the bank's purpose of "Boldly Grow the Good in Business and Life.” As an integral member of the…
Added 11 hours ago
HT
Master Data Mgmt Analyst
Husky Technologies
Bolton, ON
- Full-time
…updating master data records in the appropriate systems in compliance with business policies, documented procedures and data quality…

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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