Bilingual Manager Life & Disability Claim Management - Jobs in Ontario

Job Description

Manager, Life and Disability Claim ManagementSummaryThe Manager, Life and Disability Claim Management will be responsible for the daily management of a disability claims team. You will be focused on providing exceptional customer service to our clients, effective and efficient management of claims, and supporting and developing our claims managers.The incumbent works within defined procedural constraints and under the general supervision of the Director, Life and Disability Claims.Responsibilities

• Build a stable and collaborative team of disability claim management professionals
• Coach and mentor team members; identify employee training and development needs; participate in the hiring and employment processes for team members; set employee goals and objectives, optimize employee and team performance
• Deliver/support a comprehensive learning program to new employees and provide ongoing training support to team members in the effective management of claims
• Provide ongoing coaching and quality assurance by monitoring, observing and reviewing files to ensure sound decision making and timely customer service and adherence to standard operating procedures
• Monitor case management decisions to ensure that workload and case management activity is appropriately supported by claim management best practices
• Ensure the team is optimally staffed and operating efficiently and effectively within established best practices and service standards
• Establish and meet/exceed team performance metrics
• As a process owner for claim management, lead and report on operational service, quality and efficiency metrics
• Manage successfully third party relationships
• Foster ongoing working relationship with reinsurers and facilitate training and development,
• Build strong relationships with our Plan Sponsors, working in partnership with them to address their workplace absence issues
• Ensure compliance with contract terms, legislation, government programs, industry standards, department best practices and overall adjudication protocols and service standards
• Facilitate daily team interaction and team meetings to foster a collaborative learning environment
• Participate in the development, management and communication of process changes, including maintenance of process documentation, letters, forms and other documents
• Identify opportunities to improve operational processes; develop/support and implement training programs and workflow and process improvements
• Act as a claims management and contract subject matter expert with all internal and external stakeholders
• Manage 2nd level appeals; refer 3rd level appeals to the Company Ombudsman
• Liaise with legal services and key internal stakeholders on litigation matters, findings and recommendations
• Develop and maintain Distribution Partner and Customer relationships
• Engage in case management related activities as required
• Participate in the development of the department budget and expense management
• Lead or participate in projects and coordinate resources and user acceptance testing to ensure success of projects

Skills / Knowledge / Education

• Completion of a university degree in business, social sciences or health sciences
• 5+ years of Supervisory and Disability Claim Management and/or the Rehabilitation Services field experience
• Supervisory experience
• Knowledge and familiarity with of medical terminology
• Solid knowledge of relevant provincial employment legislation and legal requirements
• Knowledge of word processing, spreadsheet, email, internet and database software
• Extensive knowledge of insurance industry
• Bilingualism (English/French) is an asset
• CEBS or industry Claim designation is an asset
• Well developed team building, coaching and mentoring skills
• Well-developed communication and interpersonal skills
• Well-developed customer relations skills including problem-resolution & negotiation skills
• Well-developed analytical, evaluation and decision-making skills
• Ability to prioritize and balance multiple tasks or projects

Working Conditions

• Office and work-from-home environments
• Prolonged periods of concentration and attention to detail
• Prolonged periods of sitting while using a computer and/or telephone
• Frequent interruptions
• The incumbent may be required to work extended hours and/or overtime to support service requirements
• Frequent contact with emotionally distraught and upset/angry people
• Travel may be required
• Interactions:
  • Management and employees on a local and national basis
  • Distribution Partners and Customers
  • Reinsurance providers
  • Third party providers including health care provider offices, medical professionals, legal firm representatives, security and surveillance companies
  • Industry associations and government agencies
  • Other insurance companies and financial institutions

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