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 company’s claims practices are consistent, prudent, customer-centric, and aligned with the company's 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:_** + We’ll empower you to learn and grow the career you want. + We’ll recognize and support you in a flexible environment where well-being and inclusion are more than just words. + As part of our global team, we’ll support you in shaping the future you want to see. **Acerca de Manulife y John Hancock** Manulife Financial Corporation es un importante proveedor internacional de servicios financieros que ayuda a las personas a tomar decisiones de una manera más fácil y a vivir mejor. Para obtener más información acerca de nosotros, visite http://www.manulife.com . **Manulife es un empleador que ofrece igualdad de oportunidades** En Manulife/John Hancock, valoramos nuestra diversidad. Nos esforzamos por atraer, formar y retener una fuerza laboral tan diversa como los clientes a los que prestamos servicios, y para fomentar un entorno laboral inclusivo en el que se aprovechen las fortalezas de las culturas y las personas. 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Toda la información que se haya compartido durante el proceso de solicitud de adaptación se almacenará y utilizará de manera congruente con las leyes y las políticas de Manulife/John Hancock correspondientes. Para solicitar una adaptación razonable en el proceso de solicitud, envíenos un mensaje a recruitment@manulife.com . **Modalidades de Trabajo** Híbrido