Director, Claims

We are seeking an innovative and strategic-minded Director / Associate Director with deep expertise for Claims Department (Individual and/or Group Life & Health). This role is responsible for efficient and effective management of the Claims functions encompassing operations and initiatives related to end-to-end claims journey including both reimbursement and cashless processes. The focus is on delivering exceptional claims experience managing risk supporting distribution channels and fostering team development. This role also involves collaborating with various stakeholders to drive operational and service excellence in claims initiatives.

Position Responsibilities

Claims Operations

• Assist the team head in overseeing the entire claims journey including both reimbursement and cashless processes ensuring claims are handled fairly efficiently and transparently.

• Collaborate with stakeholders to manage complex cases complaints and appeals ensuring smooth professional resolution.

• Monitor team performance and KPIs focusing on continuous improvement to deliver enhance claims service that encourage customer recommendation.

• Review and refine claims processes integrating digital solutions to streamline both reimbursement and cashless processes.

• Implement and continuously enhance business workflows and capacity to meet growing business demands.

• Adjudicate and review complex or escalated claims both major and minor ensuring compliance with policy provisions and regulatory requirements.

• Regularly review and update manuals and guidelines to reflect current best practices for both reimbursement and cashless claims.

Claims Risk Management

• Collaborate with the Claims Risk Manager and Chief Medical Officer to ensure the companys claims practices are consistent prudent customer-centric and aligned with the companys risk appetite and market standards.

• Ensure consistency and integrity in the claims assessment approach and decisions across the team covering both reimbursement and cashless claims.

• Conduct claims audits per corporate requirements to ensure compliance with company guidelines legal and regulatory standards.

• Ensure the timely and competent training of claims assessors on new or revised guidelines including the nuances of cashless claims processing.

Projects and Initiatives

• Lead and participate in company and departmental projects and initiatives for operational optimization and service excellence.

• Collaborate with various stakeholders to ensure successful project execution and implementation.

• Monitor project or initiatives progress manage risks and ensure timely delivery of milestones and objectives.

• Serve as a subject matter expert on claims-related matters in projects and initiatives.

Required Qualifications

• Degree holder or above.

• At least 10 years of claims experience in Individual and/or Group Life & Health business.

• Experience in process improvement automation and digital transformation is advantageous.

• Professional qualifications (e.g. FLMI) are preferred.

• Proficient knowledge of insurance products and regulatory requirements (e.g. AML FATCA CRS).

• Able to work independently under tight schedule and lead remote teams.

• Strong attention to detail.

• Excellent interpersonal communication and change management skills.

• Strong mentoring/coaching and performance management capabilities.

• Strong relationship management skills with distributors partners and vendors.

• Strong analytical conflict resolution and problem-solving skills.

• Proficiency in MS Word MS Excel MS PowerPoint and Chinese Word Processing.

• Good command of English Chinese and Mandarin both spoken and written.

When you join our team:

• Well empower you to learn and grow the career you want.

• Well recognize and support you in a flexible environment where well-being and inclusion are more than just words.

• As part of our global team well support you in shaping the future you want to see.

About Manulife and John Hancock

Manulife Financial Corporation is a leading international financial services provider helping people make their decisions easier and lives better. To learn more about us visit 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 .