Anti-Fraud & Claims Excellence Manager

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Drive the transformation of Claims / Cases operations across East Asia on all business lines by embedding technical excellence, advanced analytics, and strategic fraud and cost management capabilities.

This role will define and execute the Claims Excellence Program, integrating data-driven insights and group-aligned frameworks to elevate performance, reduce leakage, and enhance fraud detection. The manager will work closely with Group experts to build East Asia competencies and ensure alignment with global standards.

Anti-Fraud & Costs Management Framework Development

• Define and deploy the Claims Excellence strategy across East Asia platforms, aligned with Group guidelines.
• Collaborate with Group experts to develop a regional competency framework for fraud and cost management.
• Act as Global Process Owner for Claims Excellence controls within transformation programs (e.g., auto-adjudication, iCompass).
• Reinforce and supervise the anti-fraud program, ensuring continuous improvement of tools and processes.
• Monitor fraud KPIs and ensure achievement of fraud reduction targets on all aspects of the value chain (end-customers, agents, providers).
• Manage fraud referents and support high-stakes fraud investigations.
• Apply statistical and anomaly detection techniques to identify irregularities in claims data.

Cost Management & Recovery Optimization

Data Science & Technical Analysis

Claims Quality & Medical Collaboration

Stakeholder Engagement & Change Enablement

Requirements

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