Team Leader, Quality Services

Medavie Inc.; City of Moncton; Presencial; CAD 88.000 - 99.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health and dental coverage

Wellness benefits

Flexible work environment

Leadership programs

Descripción de la vacante

Medavie Inc. in Canada is seeking a Team Leader for Life & CI Claims and Appeals. You will provide day-to-day leadership, coaching, and guidance to adjudicators and Appeals specialists, ensuring decisions are well‑reasoned and aligned with policy wording.

You will oversee complex cases, support continuous improvement, and collaborate with internal partners to refine guidelines and training materials. Bilingual French/English required with English for cross‑team collaboration.

Formación

• Post-secondary university or college degree.
• 5 years experience in Life, CI and/or Disability Claims; strong adjudication knowledge.
• 10 years in insurance (Life/Disability), incl 1 year in a supervisory role.

Responsabilidades

• Lead Life & CI Claims and Appeals Teams; coach adjudicators and specialists.
• Ensure objective, consistent appeals reviews within service standards.
• Oversee workload, case prioritization, and team performance.
• Provide technical guidance on contract interpretation and decision support.
• Identify trends and coach to improve adjudication quality.
• Support process improvements and documentation for claims operations.
• Collaborate with Operations, Medical, Legal and other partners on guidelines.

Conocimientos

Leadership

Coaching

Adjudication

Contract interpretation

Communication

Decision making

Educación

Post-secondary degree

Herramientas

Claims systems

Descripción del empleo

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.

Reporting to the Manager, Quality Services, the incumbent leads the Life & 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.

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.

What You’ll Do:

• 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.

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].

We’re recognized as one of Canada’s best places to work and are a leading provider of health solutions and insurance for 1 in 10 Canadians.

Full careers. Full lives.

Medavie is a national health solutions partner and innovative leader in healthcare delivery, benefits management, health management, and primary care. Backed by the strength of a team of 8,500+ professionals from coast to coast, we’re committed to improving the wellbeing of Canadians so that every life can be lived to the fullest. Medavie provides all‑in‑one private health insurance, public health administration, emergency medical services as Canada's largest contracted provider, as well as primary care, community health, mental health and addictions solutions, medical communications, and clinical training. As a not‑for‑profit organization, Medavie is one of Canada’s Top 100 Employers, certified by Imagine Canada for philanthropy and community engagement, and Rainbow Registered as an organization that champions diversity, equity, and inclusion.

This posting is for an existing vacancy within our organization / Ce poste est actuellement vacant au sein de notre organisation.