System & Process Lead

The Claims Process Lead is responsible for handson daily claims assessment while simultaneously leading process review standardization and continuous improvement initiatives within the MR claims operation.

This role acts as a bridge between operations process governance and system transformation ensuring stable daily performance while improving efficiency quality and compliance in claims handling.

Position Responsibilities:

Key Responsibilities

1. Daily Assessment

• Perform daily assessment of healthcare reimbursement (MR) claims ensuring accuracy policy compliance and correct benefit application.
• Handle complex highrisk or escalated cases and provide guidance to assessors when required.
• Conduct peer review / secondlevel review of assessed cases to ensure quality and consistency.
• Identify recurring errors gaps or interpretation issues during daily assessment activities.
• Support SLA and TAT achievement while maintaining quality standards.

• 2. Process Review & Improvement

• Review endtoend claims handling processes including intake assessment approval and closure.
• Identify inefficiencies manual workarounds rework drivers and compliance risks.
• Propose and implement process improvements standard operating procedures (SOPs) and work instructions.
• Lead or support process changes related to system enhancements IDP output MMS workflows or product updates.
• Ensure process alignment with internal policies regulatory requirements and audit expectations.

• 3. Stakeholder & Project Support

• Act as a key contact point between Claims Operations IT Project teams and vendors for processrelated topics.
• Support UAT golive readiness and postgolive stabilization from a process and operational perspective.
• Participate in governance forums internal reviews audits and transformation initiatives.

Required Qualifications:

• Proven experience doing daily claims assessment including complex or escalated cases.
• Solid understanding of MR claims workflows policies benefit rules and medical terminology.
• Experience in process review SOP development or operational improvement.
• Strong analytical and problemsolving skills.
• Proficiency in MS Excel and MS Office; ability to interpret operational data.
• Handson experience using claims processing systems.

Preferred Qualifications:

• Experience of acting as senior assessor quality reviewer team lead or process focal point.
• Exposure to system transformation IDP workflow changes or UAT/golive projects.
• Ability to balance daily operational delivery with improvement initiatives.
• Good communication skills with the ability to work crossfunctionally.
• English proficiency for reading medical documents business requirements and system documentation.

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 .