Case Manager I LTD

Sun Life; Portland (ME); Hybrid; USD 55,000 - 83,000; Full time

Job summary

Sun Life U.S. is seeking a Case Manager I, LTD to manage a caseload of long term disability claims and apply contractual provisions and guidelines to decisions on acceptance or denial.

You will communicate rationale clearly to claimants, while handling payment processes and associated financial risk in a hybrid role. The position emphasizes independent work with collaboration in a team, leveraging analytical and communication skills to deliver timely, accurate decisions in a supportive,

Qualifications

• Excellent written and verbal communication skills with customer service orientation.
• Ability to work independently and a team environment.
• Ability to conduct detailed claimant interviews.
• Solid critical thinking skills as well as the ability to negotiate with people.
• Demonstrated expert analytical skills with ability to assess contract language.

Responsibilities

• Manage and prioritize a group of claims on an ongoing basis while maintaining documentation.
• Obtain all pertinent information to evaluate claim credibility.
• Prepare written rationale of claim decisions based on contract provisions and medical/occupational records.
• Process claims for payment by setting up on claim paying system to ensure timely receipt of benefits.
• Assess vocational rehabilitation opportunities by working with vocational staff.
• Use investigative tools, may testify in court cases and provide depositions related to claim disputes.

Skills

Communication

Independent work

Interviewing

Critical thinking

Negotiation

Analytical skills

Job description

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide.

At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful.

When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives.

Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Job Description:

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week.

The Opportunity

In the role of Case Manager I, LTD you will have the opportunity to make a difference in the lives of individuals who have experienced a disability by successfully managing a caseload of long term disability claims. Leverage your analytical and communication skills to work independently while also thriving in a team setting. This role is key in Sun Life's journey of building the best benefits company in America. You will manage customer service, the benefit payment process and the financial risk associated with an assigned block of Long Term Disability claims. The Case Manager will apply the appropriate contractual provisions, legal guidelines, claims procedures and protocols to the facts of each claim to decide on its acceptance or denial and the duration of the benefit payment.You will be responsible for clearly communicating the rationale with confidence and sensitivity for the claimant's circumstances.

How you will contribute:

• Manage and prioritize a group of claims on an ongoing basis while maintaining appropriate documentation
• Obtain all pertinent and necessary information to evaluate claim credibility
• Prepare written rationale of claim decision based on review of contractual provisions and analysis of medical and occupational records
• Process claims for payment by setting up on claim paying system to ensure accurate and timely receipt of payment benefits
• Assess vocational rehabilitation opportunities by working with vocational staff
• Use investigative tools, may testify in court cases and provide depositions related to claim disputes based on technical expertise

What you will bring with you:

• Excellent written and verbal communication skills with customer service orientation
• Must be able to work independently and a team environment
• Ability to conduct detailed claimant interviews
• Solid critical thinking skills as well as the ability to negotiate with people
• Demonstrated expert analytical skills with the ability to think creatively and address the strengths and weaknesses of a claim and the fine distinctions in contract language

Salary Range: $55,300 - $83,000
At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive. We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate. We encourage applications from qualified individuals from all backgrounds.

Life is brighter when you work at Sun Life

At Sun Life, we prioritize your well-being with comprehensive benefits, including generous vacation and sick time, market-leading paid family, parental and adoption leave, medical coverage, company paid life and AD&D insurance, disability programs and a partially paid sabbatical program. Plan for your future with our 401(k) employer match, stock purchase options and an employer-funded retirement account. Enjoy a flexible, inclusive and collaborative work environment that supports career growth. We're proud to be recognized in our communities as a top employer. Proudly Great Place to Work Certified in Canada and the U.S., we've also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row. Visit our website to learn more about our benefits and recognition within our communities.

We will make reasonable accommodation s to the known physical or mental limitation s of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business. Please email [e-mail] request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Category:

Claims - Life & Disability

Posting End Date:

08/11/2026