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Urgent! Manager, Claims & FWA Data Analytics Career Opportunity with Prudential plc in Hong Kong

Manager, Claims & FWA Data Analytics



Job description

Prudential’s purpose is to be partners for every life and protectors for every future.

Our purpose encourages everything we do by creating a culture in which diversity is celebrated and inclusion assured, for our people, customers, and partners.

We provide a platform for our people to do their best work and make an impact to the business, and we support our people’s career ambitions.

We pledge to make Prudential a place where you can Connect, Grow, and Succeed.

This is a high-impact leadership role responsible for driving claims operational excellence and fraud intelligence across Life and Health insurance portfolios.

As Manager of Claims & FWA Data Analytics, you will lead the design and execution of data-driven strategies to optimize claims performance, monitor operational KPIs, and proactively detect and mitigate fraud, waste, and abuse.

You will be a trusted advisor to Claims, Risk, Legal, and Technology teams, enabling transformation through analytics, automation, and governance.

Why This Role Is Elite:

  • Dual Domain Leadership: Shape both claims strategy and fraud intelligence for Life & Health portfolios.
  • Operational Impact: Direct influence on claims efficiency, customer satisfaction, and cost containment.
  • Innovation-Driven: Lead the adoption of AI/ML in claims adjudication and fraud detection.
  • Strategic Visibility: High-impact role with direct reporting to senior leadership and regulators.
  • Job Responsibilities:

    1.

    Claims Operations Analytics

  • Monitor and analyze key operational metrics including Turnaround Time (TAT), Straight-Through Processing (STP) rates, First-Time Resolution, and Cost per Claim.

  • Develop and maintain performance dashboards for Claims leadership to track service levels, efficiency, and customer experience.

  • Identify bottlenecks and recommend process improvements to enhance claims adjudication speed and accuracy.

  • 2.

    FWA Detection & Prevention

  • Design and deploy predictive models and rule-based engines to detect suspicious claims behaviors and fraud typologies.

  • Lead analytics support for Special Investigation Unit (SIU), Legal, and Compliance teams.

  • Quantify financial impact of FWA cases and support recovery and litigation efforts.

  • 3.

    Strategic Claims Insights

  • Analyze claims trends across Life and Health products to identify leakage, inefficiencies, and improvement opportunities.

  • Provide actionable insights to Claims leadership on provider behavior, customer patterns, and operational risks.

  • Support strategic initiatives such as claims automation, digital adjudication, and benefit optimization.

  • 4.

    Data Infrastructure & Technology Enablement

  • Collaborate with IT and Data Engineering to build scalable data pipelines and analytics platforms.

  • Evaluate and integrate third-party tools (e.g., OCR/NLP for document processing, fraud scoring engines, consortium databases).

  • 5.

    Governance, Compliance & Reporting

  • Ensure analytics processes comply with Hong Kong Insurance Authority (IA) regulations and internal audit standards.

  • Prepare executive-level reports and regulatory submissions on claims performance and fraud risk.

  • 6.

    Leadership & Collaboration

  • Mentor junior analysts and foster a high-performance analytics culture.

  • Lead cross-functional task forces on claims transformation, fraud prevention, and regulatory readiness.

  • Represent the company in industry forums and consortiums on claims analytics and fraud intelligence.

  • Job Requirements:

  • Bachelor’s or Master’s degree in Data Science, Actuarial Science, Statistics, Insurance, or related field.

  • 6–10 years in Life & Health insurance claims analytics, with deep exposure to both operational and fraud domains.

  • Proven track record in driving claims transformation through data.

  • Experience in managing claims KPIs, STP initiatives, and fraud detection programs.

  • Advanced proficiency in Python, R, SQL, Power BI/Tableau

  • Experience with machine learning, NLP, and automation tools

  • Familiarity with claims systems (e.g., Guidewire, Duck Creek) and cloud platforms (Azure, AWS)

  • Preferred Certifications: Certified Fraud Examiner (CFE), ACII / FLMI / CPCU, Data Science or AI certifications


  • Required Skill Profession

    Operations Specialties Managers



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