Case Manager – Life & Disability Services

TEEMA Solutions Group; Edmonton; Hybrid; CAD 60,000 - 80,000; Full time

Job summary

A Canadian solutions provider is seeking Case Managers to manage Short-Term and Long-Term Disability claims. This role involves developing treatment plans, collaborating with stakeholders, and ensuring compliance with guidelines. The ideal candidate will have a health-related degree, experience in claims management, and strong analytical and communication skills. Flexibility and a team-oriented approach are essential.

Qualifications

• Degree or diploma in a health-related field is an asset.
• Experience related to disability claims management.
• Strong analytical skills and detail orientation.
• Excellent written and verbal communication skills.

Responsibilities

• Adjudicate Short-Term and Long-Term Disability claims.
• Plan, implement, and evaluate case management principles.
• Ensure proper application of rules and regulations.
• Communicate with various departments for claims-related information.

Skills

Analytical skills

Detail orientation

Organizational skills

Team-player skills

Communication skills

Education

Degree or diploma in a health-related field

Tools

Microsoft Word

Microsoft Excel

Job description

We are continuing to grow our team and are looking for additional Case Managers. Working in a flexible work style arrangement, our Case Managers are responsible for managing Short-Term Disability and Long-Term Disability claims. You will manage the initial decision making on the claim as well as ongoing management including developing and monitoring treatment plans, return to work planning and rehabilitation programs. As a Case Manager, you will develop relationships with involved parties and provides expert advice to internal and external customers on a daily basis.

DESCRIPTION

Adjudicate Short-Term Disability and Long-Term Disability claims.

Ensure proper application of rules and regulations as outlined in the Group Policy and in accordance with the Canadian Life and Health Association (CLHIA) guidelines.

Plan, implement and evaluate sound case management principles.

Responsible for the issuance of correct benefit payment.

Responsible for professional and accurate verbal and written communication with all stakeholders.

Manage assigned portfolio and become subject matter expert on assigned groups.

Communicate with other Alberta Blue Cross departments including Medical Underwriting, Group Underwriting, Sales, Group Administration, and Accounting to provide and exchange information regarding claims activities, eligibility and financial transactions.

REQUIREMENTS

Degree or diploma in a health-related field such as in Nursing, Kinesiology, Rehabilitation Medicine or Social Work is an asset.

Experience related to disability claims management.

Knowledge of the insurance benefit industry is considered an asset.

Strong analytical skills, detail orientation and organizational skills.

Demonstrated excellence in the decision-making process especially when under pressure.

Strong team-player skills and cooperative attitude.

Excellent written and verbal communication skills.

Proven strength in the areas of flexibility, innovation and independence.

Ability to deal effectively with external stakeholders and coworkers.

Proficiency with Microsoft Word and Excel is required.

Certified Disability Management Professional (CDMP) would be an asset.

Enrollment in LOMA or other industry related courses would be an asset.

This position will remain open until a suitable candidates are selected.