Third Party Administration Consultant

at  Manulife

Third Party Administrator (TPA) audits are conducted to identify business risks within Affinity and Group Benefits and to make appropriate recommendations related to efficiency, compliance and/or risk management.
Reporting to the Director, Operations Affinity the incumbent will contribute in the development of audit plans and execute regular operational audits including due diligence audits on the TPAs within Affinity and Group Benefits. This role requires strong relationship and communication skills when working with the various TPAs and other departments/teams within the organization.
In Affinity, the TPAs provide services on behalf of our plan members and the TPAs are plan sponsors, professional, alumni and retiree associations, retailers, travel partners and other groups/organizations that have a strong affinity with their members or customers. In Group Benefits, the TPAs are selected by the plan sponsors and represent both Corporate and Trustee partnerships such as unionized trade workers and partnerships encompassing the small-mid market segment.

REQUIRED QUALIFICATIONS:

• A minimum of 5 years in the Insurance industry with experience in operational functions.
• University Degree is required or equivalent work experience.
• Ability to represent Manulife in a professional and positive manner to external clients and stakeholders.
• Excellent interpersonal skills with the proven ability to influence and negotiate solutions to issues.
• Excellent oral and written communication skills.
• Excellent analytical and problem-solving skill.
• Ability to understand business processes and their risk implications, reach appropriate conclusions, and make value-added and practical recommendations.
• Leads by example, takes initiative, demonstrates results oriented driven.
• Proven technical proficiency Excel and Word.
• Excellent organization, time management and prioritization skills.
• Ability to develop and re-engineer processes with TPAs and business units within Affinity and Group Benefits.

• Third Party Administration Consultant is accountable for planning and leading audits related to the Third Party Administrators (TPA) in both Affinity and Group Benefits that administer business on behalf of Manulife.
• Plan and perform regular audits of TPAs to ensure coverage is being administered in accordance with the terms of the contract or agreement. In accordance with the established audit schedule, develop audit scope, issue audit plans, confirmation letters, and perform audit fieldwork to meet the agreed upon deadline to issue the final audit report. This includes evaluating audit controls in place to mitigate the risks in place at the TPA through the review of the control objectives and completion of all assigned audit work (i.e. PCI Compliance, Agent Licensing Requirements, CASL, Provincial Unclaimed Property Reporting etc). Ensure compliance, data integrity and risk management controls exist. Provide constructive feedback and recommendations in a professional manner. Maintain and enhance audit protocols to ensure the current strategy is effective, efficient and adds value to all parties involved. In addition, the Consultant, Third Party Administrators will work with relationship managers and other departments.
• Writes/issues TPA Agreements and any required amendments for TPAs in both Affinity and Group Benefits to ensure the Agreement accurately reflects the services to be provided and is written in accordance with OSFI’s and Manulife’s outsourcing policies. Once Agreements are issued, feedback is often received from the TPA and negotiation of contract provisions occurs in association with the respective Legal Department.
• Completes a weekly rotation of the shared inboxes and associated tasks which includes handling of team correspondence related to TPA health and dental claim inquiries, requests from internal stakeholders, ad-hoc requests, etc.
• Responsible for the completion of the annual Bond Insurance application.
• Support risk management and compliance activities, taking part and/or contributing to other projects and tasks as assigned.
• Maintain positive successful relationships with key internal stakeholders and with key contacts within each Third Party organization.
• Weekly rotation includes handling of Memorandum of Understandings (MoUs) which are legal documents issued between a Plan Sponsor and their Third Party Administrator that Manulife is acknowledging.
• Approvals of TPA funding initiated by the TPA Coordinator (wire transfer/direct deposit) as necessary.
• Monthly handling of responsibilities related to Unclaimed Property and associated reporting. This includes providing monthly reporting to the TPAs and internal reporting.
• As required, provide support and back up functions when the TPA Coordinator is unavailable. This will include learning the role/responsibilities for all aspects of funding of TPAs, including multiple applications surrounding accounting/claims/treasury and any other functions related to the funding of the Corporate and Trustee TPA’s.