Manager, Claims & FWA Data Analytics
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Job Location:
Monthly Salary:
Posted on:
25-10-2025
Vacancies:
1 Vacancy
Job Summary
Prudentials purpose is to be partners for every life and protectors for every future. Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured for our people customers and partners. We provide a platform for our people to do their best work and make an impact to the business and we support our peoples career ambitions. We pledge to make Prudential a place where you can Connect Grow and Succeed.
This is a high-impact leadership role responsible for driving claims operational excellence and fraud intelligence across Life and Health insurance portfolios. As Manager of Claims & FWA Data Analytics you will lead the design and execution of data-driven strategies to optimize claims performance monitor operational KPIs and proactively detect and mitigate fraud waste and abuse. You will be a trusted advisor to Claims Risk Legal and Technology teams enabling transformation through analytics automation and governance.Why This Role Is Elite:
- Dual Domain Leadership: Shape both claims strategy and fraud intelligence for Life & Health portfolios.
- Operational Impact: Direct influence on claims efficiency customer satisfaction and cost containment.
- Innovation-Driven: Lead the adoption of AI/ML in claims adjudication and fraud detection.
- Strategic Visibility: High-impact role with direct reporting to senior leadership and regulators.
Job Responsibilities:
1. Claims Operations Analytics
Monitor and analyze key operational metrics including Turnaround Time (TAT) Straight-Through Processing (STP) rates First-Time Resolution and Cost per Claim.
Develop and maintain performance dashboards for Claims leadership to track service levels efficiency and customer experience.
Identify bottlenecks and recommend process improvements to enhance claims adjudication speed and accuracy.
2. FWA Detection & Prevention
Design and deploy predictive models and rule-based engines to detect suspicious claims behaviors and fraud typologies.
Lead analytics support for Special Investigation Unit (SIU) Legal and Compliance teams.
Quantify financial impact of FWA cases and support recovery and litigation efforts.
3. Strategic Claims Insights
Analyze claims trends across Life and Health products to identify leakage inefficiencies and improvement opportunities.
Provide actionable insights to Claims leadership on provider behavior customer patterns and operational risks.
Support strategic initiatives such as claims automation digital adjudication and benefit optimization.
4. Data Infrastructure & Technology Enablement
Collaborate with IT and Data Engineering to build scalable data pipelines and analytics platforms.
Evaluate and integrate third-party tools (e.g. OCR/NLP for document processing fraud scoring engines consortium databases).
5. Governance Compliance & Reporting
Ensure analytics processes comply with Hong Kong Insurance Authority (IA) regulations and internal audit standards.
Prepare executive-level reports and regulatory submissions on claims performance and fraud risk.
6. Leadership & Collaboration
Mentor junior analysts and foster a high-performance analytics culture.
Lead cross-functional task forces on claims transformation fraud prevention and regulatory readiness.
Represent the company in industry forums and consortiums on claims analytics and fraud intelligence.
Job Requirements:
Bachelors or Masters degree in Data Science Actuarial Science Statistics Insurance or related field.
610 years in Life & Health insurance claims analytics with deep exposure to both operational and fraud domains.
Proven track record in driving claims transformation through data.
Experience in managing claims KPIs STP initiatives and fraud detection programs.
Advanced proficiency in Python R SQL Power BI/Tableau
Experience with machine learning NLP and automation tools
Familiarity with claims systems (e.g. Guidewire Duck Creek) and cloud platforms (Azure AWS)
Preferred Certifications: Certified Fraud Examiner (CFE) ACII / FLMI / CPCU Data Science or AI certifications
Prudential is an equal opportunity employer. We provide equality of opportunity of benefits for all who apply and who perform work for our organisation irrespective of sex race age ethnic origin educational social and cultural background marital status pregnancy and maternity religion or belief disability or part-time / fixed-term work or any other status protected by applicable law. We encourage the same standards from our recruitment and third-party suppliers taking into account the context of grade job and location. We also allow for reasonable adjustments to support people with individual physical or mental health requirements.
Required Experience:
Manager
Key Skills
- Adobe Analytics
- Data Analytics
- SQL
- Attribution Modeling
- Power BI
- R
- Regression Analysis
- Data Visualization
- Tableau
- Data Mining
- SAS
- Analytics
About Company
พรูเด็นเชียล ประกันชีวิต (ประเทศไทย) มุ่งมั่นที่จะช่วยให้คุณก้าวหน้าในชีวิต โดยเราให้ความใส่ใจอย่างเต็มที่เพื่อการบริการที่เป็นเลิศแก่คุณ ค้นหาวิธีที่เราจะสามารถช่วยเหลือคุณได้ที่นี่ ... View more
