Team Leader, Quality Services

Medavie; Canada; On-site; CAD 88,000 - 99,000; Full time

Job summary

Medavie in Canada is seeking a Team Leader for Life & CI Claims and Appeals to guide adjudicators and specialists, ensuring consistent, high‑quality decisions. You will drive process improvements, collaborate with cross‑functional partners, and mentor staff to achieve service excellence.

The role requires a post‑secondary degree and 5+ years in Life/CI/Disability claims, with senior experience and French/English bilingual abilities. Competitive benefits and leadership development are offered.

Qualifications

• Post‑secondary university or college degree.
• Minimum 5 years previous experience in Life, CI and/or Disability Claims; Strong understanding of adjudication and Appeals processes.
• 10 years of experience in the insurance industry (Life and Disability), including 1 year in a supervisory capacity in Life and Disability Case Management.
• Demonstrated leadership with the ability to coach, support team performance, and drive high engagement effectively.
• Excellent communication; strong analytical and decision‑making skill; ability to manage competing priorities; deep understanding of contract wording and claims practices.
• Bilingualism in French and English. English proficiency is required to perform the duties of the role, which include daily collaboration with teams and partners outside Québec who operate primarily in English.

Responsibilities

• Lead Life & CI Claims and Appeals Teams with day‑to‑day guidance.
• Support adjudicators with complex, sensitive, or precedent‑setting claims.
• Ensure Appeals reviews are objective, consistently, and within service standards.
• Oversee workload distribution, case prioritization, and team performance.
• Provide technical expertise on Life, CI, and Disability contract interpretation.
• Review complex or escalated cases, offering recommendations or direction as needed.
• Identify trends in decision‑making and provide coaching to strengthen adjudication quality.
• Collaborate with Operations, Medical, Legal, and other partners to refine guidelines and procedures.
• Develop and maintain training materials and reference documents.
• Prepare reports on team performance and communicate with leadership.
• Set individual goals, conduct performance reviews, and develop action plans to support growth.

Skills

Leadership

Coaching

Communication

Analytical thinking

Education

Post-secondary degree

Insurance claims training

Tools

Claims systems familiarity

Job description

Position Type

Permanent

If you’re looking for a fulfilling career that can make a real difference in your life, and the lives of others, you’ve come to the right place.

As a national health solutions partner, we put people first in everything we do — and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year.

Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest — and it’s reflected in our award‑winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today.

Reporting to the Manager, Quality Services, the incumbent leads the Life & Critical Illness (CI) Claims team and the Appeals team, which is responsible for reviewing appeals across all Life and Disability claim lines. The role ensures consistent, fair, and timely adjudication practices, supports complex case decision‑making, and promotes high‑quality service delivery.

The incumbent provides direction, coaching, and technical expertise to adjudicators and Appeals specialists, ensuring decisions align with contractual provisions, industry standards, and Medavie’s values. This role also contributes to the development and refinement of claims processes, training materials, and documentation to support operational excellence.

The Team Leader acts as a key liaison between Quality Services, Claims Operations, Medical Services, Legal, and other internal partners. The role supports departmental initiatives, participates in cross‑functional projects, and fosters a culture of continuous improvement and professional development.

What You’ll Do

As a Team Leader at Medavie, you will embody our values of Caring, Accountable, Responsive, Innovative and Community‑minded while fostering an inclusive, high‑performing team environment. Success in this role requires the ability to build organizational knowledge, deliver a strong customer experience, plan and organize effectively, execute against priorities, adapt to change, communicate and collaborate across teams, and coach and develop others to achieve individual and team success.

Leadership of Life & CI Claims and Appeals Teams

• Provide day‑to‑day leadership, coaching, and guidance to Life & CI adjudicators and Appeals specialists.
• Support adjudicators with complex, sensitive, or precedent‑setting claims.
• Ensure Appeals reviews are completed objectively, consistently, and within service standards.
• Oversee workload distribution, case prioritization, and team performance.

Adjudication Quality, Case Review & Decision Support

• Provide technical expertise on Life, CI, and Disability contract interpretation.
• Review complex or escalated cases, offering recommendations or direction as needed.
• Ensure decisions are well‑reasoned, clearly documented, and aligned with policy wording and best practices.
• Identify trends in decision‑making and provide coaching to strengthen adjudication quality.

Process Improvement, Documentation & Operational Support

• Identify opportunities to enhance claims processes, workflows, and decision‑making tools.
• Collaborate with Operations, Medical, Legal, and other partners to refine guidelines and procedures.
• Support the development and maintenance of training materials, job aids, and reference documents.
• Participate in system or process enhancement initiatives impacting Life, CI, or Appeals workflows.

Reporting, Insights & Stakeholder Communication

• Prepare and deliver reports on team performance, Appeals outcomes, trends, and emerging issues.
• Communicate updates, risks, and recommendations to leadership.
• Maintain strong relationships with internal partners to ensure alignment on claims practices and service expectations.

Staff Development & Performance Management

• Set individual goals, conduct performance reviews, and develop action plans to support growth.
• Provide ongoing coaching, training, and mentorship to build technical expertise and decision‑making confidence.
• Foster a collaborative, supportive, and high‑performance team culture.

What You Bring

• Post‑secondary university or college degree
• Minimum 5 years previous experience in Life, CI and/or Disability Claims; Strong understanding of adjudication and Appeals processes
• 10 years of experience in the insurance industry (Life and Disability), including 1 year in a supervisory capacity in Life and Disability Case Management.
• Demonstrated leadership with the ability to coach, support team performance, and drive high engagement effectively.
• Excellent communication; strong analytical and decision‑making skill; ability to manage competing priorities; deep understanding of contract wording and claims practices.
• Bilingualism in French and English. English proficiency is required to perform the duties of the role, which include daily collaboration with teams and partners outside Québec who operate primarily in English.

What’s In It For You

• A purpose‑driven organization dedicated to improving the well‑being of Canadians.
• A comprehensive benefits plan, including health and dental coverage that is 100% employer paid from day one, plus wellness benefits, health resources, and fitness center discounts.
• A flexible work environment that supports work–life balance and empowers employees to thrive.
• Robust professional development opportunities, including leadership programs, ongoing learning, and career growth pathways.
• A collaborative and inclusive culture where your expertise is valued, your voice matters, and your contributions help shape our product strategy.
• The opportunity to lead a dedicated team that directly contributes to the quality of service delivered to members and clients.

Pay Range

88,158 - 99,177 CAD

The Base Pay range may vary depending on the successful candidate or other relevant job‑related factors such as knowledge, skills, qualifications, experience and education/training. In addition to Base Pay, eligible Medavie employees may participate in various performance‑based incentive programs. Payments under these programs are discretionary and subject to both individual and organizational results.

We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs. We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws. We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted.

While Medavie may use automated tools, including AI, to support application screening, candidates are expected to complete all recruitment interactions independently—without AI assistance to ensure a fair and equitable process.

If you experience any technical issues throughout the application process, please email: [e-mail].