Manager, Group Health Claims

The Opportunity: At Equitable we believe great things happen when we work together. Were a Canadian mutual company driven by purpose - putting people first and helping Canadians protect today and prepare for tomorrow. If youre passionate about making a difference and growing your career in an inclusive and collaborative environment wed love to hear from you. Our culture is built on care passion and curiosity. We put people above all else strive to be our best and welcome new ideas to deliver positive is a high-impact leadership role within Group Health Claims where you will drive operational excellence lead a high-performing team and optimize claims processes to enhance service efficiency and cost effectiveness. Youll play a key role in delivering strategic initiatives improving performance and strengthening collaboration across teams and one of the regions top employers and be part of something that truly makes a Arrangements: This is a hybrid role. You will work in our office in Waterloo ON a minimum of two (2) assigned consecutive days every other week plus a fifth (5th) assigned day per month. You are welcome to work from the office more than the minimum requirement and there may be some roles that are required to work in our office more than the minimum youll do:Lead and manage the day-to-day operations of the Group Health Claims team to ensure claims are processed accurately and within established service standardsProvide leadership coaching and direction to a team of claims adjudicators including performance management conflict resolution and career developmentAllocate and monitor team workload to ensure optimal staffing levels and timely completion of daily weekly and monthly deliverablesPartner with the leadership team to achieve key performance indicators and continuously improve operational efficiencyDevelop and oversee training programs ensuring staff accuracy knowledge development and cross-functional capability buildingDrive and implement cross-functional projects focused on improving processes reducing costs and increasing overall effectivenessAct as the primary point of contact for internal and external audits coordinating activities reviewing findings and implementing corrective actionsCollaborate with external partners to maintain a strong and effective claims management ecosystemIdentify and implement ongoing process improvements to enhance service quality and operational efficiencyManage escalated claims issues and provide resolution for complex cases ensuring strong client and stakeholder relationshipsOversee reporting of operational metrics and performance data applying insights to improve team outcomesManage departmental budgets monitor expenses and identify opportunities for cost optimizationEnsure compliance with industry regulations company policies and governance standardsMaintain strong relationships with internal departments group offices and third-party providers to support service deliveryStay informed on industry trends legislative changes and competitor practices through involvement in industry forums and associationsPartner closely with the Dental Claims Manager to align resources and achieve shared team objectivesWhat youll bring:Post-secondary education or an equivalent combination of education and relevant work experience57 years of progressive leadership experience ideally within group health claims or insurance environmentsStrong medical and drug knowledge with in-depth understanding of group health benefits contracts and applicable legislationDemonstrated ability to lead mentor and develop high-performing teams in a fast-paced operational settingProven experience managing workflows optimizing processes and driving continuous improvement initiativesExcellent interpersonal and relationship management skills with the ability to collaborate across internal teams and external partnersStrong analytical problem-solving and decision-making skills with the ability to manage competing priorities and deadlinesEffective communication skills both written and verbal with the ability to influence and engage stakeholders at all levelsExperience with project management and cross-functional initiatives; familiarity with agile methodologies is an assetSolid understanding of budget management forecasting and cost control practicesStrong attention to detail organizational skills and ability to manage complex operational tasksProficiency in Microsoft Office (especially Excel and Word) and experience with systems such as BMS and OnBase is an assetChange leadership mindset with the ability to guide teams through transformation and continuous improvement initiativesWhats in it for you:Career Growth: Regular learning sessions and developmentopportunitiesTotal Rewards: Incentive pay annual salary reviews employer-paid benefits and pensionmatchingTime Away: Competitive vacation plus one paid volunteer day each yearFlexibility: Healthy work-life balance with employee wellness always top of mind complemented by a dress for your day Equitable were committed to fair pay and an inclusive accessible hiring experience. If you need accommodations or alternative formats at any stage just reach out to us at Were happy to base pay will be based on your skills qualifications experience and addition to your salary this role is eligible for a discretionary annual incentive award tied to business performance plus a wide range of competitive benefits. If youre selected to move forward our Talent Acquisition team will walk you through all the details of our total rewards program so you know exactly whats To: Director Group Claims Department: Group Claims Term: Permanent Full-Time

Required Experience:

Manager

Employment Type : Full Time
Experience: years
Vacancy: 1