Senior Case Manager

Job Overview

Working under minimal supervision, this role supports Wawanesa’s success through the ongoing case management of complex Short-Term Disability, Long-Term Disability, Creditor, and / or Disability Income claims for Group & Individual business.

This role is responsible for escalated claims, complaints, litigation, and other complex claims issues.

Job Responsibilities

• Review, assess and render decisions on disability and other claims through the development of claims management strategies to bring claims to succession resolutions.
• Conduct complex investigations as required on existing case files.
• Collaborate with clients and claimants, reinsurers, medical practitioners and providers to obtain claims documentation, provide updates as to claims status and respond to inquiries.
• Review complex and differing policy wordings to ensure decisions are made within the policy’s scope.
• Communicate decisions verbally and in writing in an effective and courteous manner.
• Address claims escalations, complaints, and / or claims litigation to a successful resolution.
• Coordinate rehabilitation and other services to assist with successful return to work, including complex programs with multiple providers.
• Maintain records of individual workload and claims adjudication.
• Respond to claimant or other inquiries within company service standards.
• Will perform other duties as assigned.

Qualifications

• Post-secondary degree / diploma in a medical or related field, or an equivalent combination of education and experience is required.
• Minimum five (5) years’ case management or related experience is an asset.
• Actively working towards or completion of Case Management or NIDMAR courses is considered an asset.
• Bilingual (read / write / converse) in French is considered an asset.
• Excellent computer skills and knowledge of the Microsoft Office suite is required, including the ability to perform complex calculations using Excel or otherwise.
• Good working knowledge of SharePoint is considered an asset.
• Excellent ability to interpret and apply contract wordings.
• Strong time management and organizational skills with the ability to establish priorities among competing deadlines while maintaining service standards.
• Strong attention to detail with the ability to identify relevant information and potential impacts.
• Strong communication and negotiation skills, with the ability to communicate at the right level for the intended audience, including internal and external customers through written or verbal communication.
• Ability to handle sensitive information while following confidentiality guidelines / legislation.

Wawanesa is proud to be one of , a in Canada and a in Canada recognizing an exceptional place to work!

Diversity Equity, Inclusion & Belonging

Wawanesa is an equal opportunity employer and is committed to fostering a diverse workforce that is equitable and inclusive for all.

Wawanesa provides equal employment opportunity to all employees and applicants without regard to an individual’s protected status : race / ethnicity, colour, religion, creed, sex or gender, sexual orientation, gender identity or expression, family or marital status, pregnancy / childbirth or related conditions, national origin, disability, military or veteran status, or any other protected status.

Disability or medical-related accommodations are available upon request throughout all aspects of the recruitment and selection process.