Team Leader, Quality Services

Guardian Ambulance; New Brunswick; Presencial; CAD 85.000 - 115.000; Tempo integral

Resumo da vaga

Medavie is seeking a Team Leader for Life & CI Claims and Appeals to drive performance across teams. You will provide coaching, ensure fair adjudication, and push for process improvements within contractual and policy guidelines.

The role emphasizes supporting complex cases, coordinating with stakeholders, and developing training materials to enhance service quality.

Qualificações

• 5+ years of Life, CI and/or Disability claims experience.
• 10+ years in the insurance industry with leadership exposure.
• At least 1 year in a supervisory capacity in Life/Disability.

Responsabilidades

• Lead Life & CI Claims and Appeals Teams with daily coaching.
• Guide adjudicators on complex or precedent-setting claims.
• Ensure objective, consistent, timely appeals reviews.
• Oversee workload, prioritization, and team performance.
• Identify improvements to claims processes and tools.
• Report team performance and trends to leadership.
• Develop staff through coaching and formal reviews.

Conhecimentos

Life & CI claims experience

Disability claims experience

Supervisory leadership

Formação

Post-secondary university or college degree

Descrição da vaga

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:

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 Disabilit