Quality Program Specialist

Canada Life; Lasalle; On-site; CAD 67,000 - 115,000; Full time

Benefits offered by this job

Education reimbursement up to CAD 2,0

Health & Wellness benefits

Volunteer day

Company-matching pension plan

Job summary

Canada Life is seeking a detail-oriented professional to audit disability claim samples for quality and policy compliance across its Disability Management Services offices in Canada.

The role focuses on identifying trends, training needs, and reporting variances, while collaborating with Case Managers and Team Managers to discuss results and coach teams toward improved outcomes. Emphasis on process improvements and adherence to standards.

Qualifications

• 4+ years disability claims experience
• Proficient knowledge of medical terminology, benefit policy, best practices and procedures
• Ability to coach and provide constructive feedback
• Strong written and verbal communication skills
• Ability to work independently and within a virtual team environment

Responsibilities

• Audit disability claim samples for quality and policy compliance
• Identify trends and training needs, report variances
• Collaborate with Case Managers and Team Managers to discuss results
• Recommend process improvements and changes to training materials
• Contribute to continuous improvement and quality program standards
• Participate in management calls to review results
• Ensure compliance with national operating model and training tools
• Provide clear, practical recommendations to improve customer outcomes

Skills

Auditing

Quality assurance

Disability claims

Communication

Bilingualism

Coaching

Negotiation

Analytical thinking

Education

Post-secondary diploma

Tools

ODIS/DCT/BEN

MS Office

Job description

Temporary Full Time

The successful candidate will be responsible for reviewing samples of Disability, Case Managers files to ensure quality claims assessment and management. The incumbent will use their expertise to identify trends, areas that require training, and interpret and report on variances for their local or assigned Disability Management Services office. The position will also assist in the identification and communication of areas for improved processes and will address discrepancies directly with the Team Managers in the Disability Management Services office, and negotiate, if required, with Directors.

What You Will Do

• Actively live our values of putting the customer first in all that we do, integrity, partnership, fostering employee engagement, committing ourselves to sustainability, supporting our communities
• Perform focused and comprehensive audits initiated by head office
• Compile and analyze results within the assigned Disability Management Services office to identify trends, strengths, areas of concern and to provide recommendations to the Disability Management Services office on matters that impact morbidity and customer service
• Partner with the individual Case Managers and/or Team Managers, to review and discuss results, provide coaching, and to effectively handle differing opinions and negotiate alternative outcomes
• Based on audit findings, support ongoing continuous improvement by recommending changes to training and resource materials, quality program standards, and office procedures
• Participate in conference calls/management team meetings with the Quality Program Team and Disability Management Services office management team to review results
• Communicate and collaborate with various peers and leaders across business functions and departments
• Review samples of disability claim files from Case Managers to ensure:
• comprehension and appropriate application of benefit policy, best practices and procedures
• proper assessment and application of contractual limitations/provisions
• accuracy of systems coding
• correct interpretation of medical and claim information
• critical thinking is carried out in claims assessment and decisions
• Canada Life philosophies are applied in developing claim management plans and making appropriate medical and rehabilitation referrals
• authority parameters are followed in accordance with the national operating model
• compliance with training curriculum, job aids and training tools.

What You Will Bring

• Bilingualism is an asset
• Completed post secondary diploma or equivalent
• 4+ years disability claims experience
• Strong professional communication skills, both written and oral, including:
• An ability to explain complex topics in plain language
• An ability to negotiate with people in a variety of roles
• An ability to coach in a positive manner
• Proven experience providing excellent customer service
• Proficient knowledge of medical terminology, benefit policy, best practices and procedures
• Adapts to organizational change, best practice adoption and improvement, including supporting the implementation and adherence to changes in processes and practices
• Excellent organizational and analytical skills with the ability to manage multiple competing projects and priorities under time pressure without compromising quality
• Ability to work independently and within in a virtual team environment, facilitating and contributing to work across geographies and across other functional teams
• Strong decision-making and problem solving skills with a customer centric approach
• Proficient computer skills in Microsoft Excel
• Proficient knowledge of ODIS/DCT/BEN and MS Office
• Knowledge of absence services products an asset
• Reliability Status security clearance - this is a personnel security status that is required before an employee can gain access to Protected B information, assets or work sites as outlined by the Government of Canada website

Given the size and scope of our organization, we have the flexibility for this position to be located in any of the 14 Disability Management Services Offices (DMSO) located across Canada (Toronto, Winnipeg, Vancouver, Langley, London, Halifax, Hamilton, Ottawa, Montreal, Edmonton, Calgary, Pickering, Regina, St. John’s).

The base salary for this position is between $66,700 - $114,700 annually. This represents base salary only and does not represent other variable compensation components of our total compensation ( i.e. annual bonus, commission etc). If you are selected to move forward in our recruitment process, your recruiter will be able to discuss additional details of our total rewards program with you.

Career opportunities will be open a minimum of 5 business days from the date of posting, closing dates will vary depending on the search activity. All applications received will be reviewed on a rolling basis.

Grow with Canada Life

We’re united by a shared purpose: to improve the financial, physical and mental well-being of Canadians. Our company is trusted by 1 in 3 Canadians and contributes to the strength of communities across the country.

We’re looking for people who live our values everyday: we step up, we do the right thing, and we deliver – for our customers, communities and each other. Are you someone who always strives to do the right thing, who steps up for themselves and others, and who delivers with impact? Then we want to hear from you!

What we offer

• Career Development: Opportunities for career advancement, access to industry-leading learning programs and up to$2,000 annually towards education reimbursement.
• Health & Wellness:Flexible health and dental benefits, plus a $5,000 mental health benefit to support your well-being.
• Time Off:In addition to regular vacation and personal days, we support community involvement with a volunteer day.
• Financial Security:Company-matching pension plan,share ownership program and additionalinvestment options.
• Rewards and Recognition: Employee recognition programs, service milestone celebrations, employee discounts and more!
• Emphasis on Community: We provide a workplace where employees feel connected and supported through Employee Resource Groups (ERGs), mentorship programs, social clubs and events.

Learn more about Canada Life.

We’re committed to removing barriers and ensuring equal access to employment. Applicants requiring reasonable accommodation during the application process may contact [e-mail]. All information provided will be handled in accordance with applicable laws and Canada Life policies.

Canada Life would like to thank all applicants, however only those who qualify for an interview will be contacted.