Case Manager

3 weeks ago

Edmonton, Alberta, Canada TEEMA Full time
Job Title: Case ManagerJob ID: ME Location: Edmonton, ABOverview:Our client is an Alberta-based, not-for-profit organization dedicated to delivering exceptional customer experience and community leadership. They're committed to providing the best health coverage to over 1.8 million members and take an active role in promoting the wellness of all Albertans. They currently have an opening for a permanent full time Case Manager which allows for flexible work arrangements. This position is responsible for managing an assigned block of Short Term Disability and Long Term Disability claims. The Case Manager is responsible for the initial decision making on the claim as well as ongoing management that includes developing and monitoring treatment plans, return to work planning and rehabilitation programs. The Case Manager develops relationships with involved parties and provides expert advice to internal and external customers on a daily basis. What you will be doing:
  • Adjudicate Short Term Disability and Long Term Disability claims.
  • Ensure proper application of rules and regulations as outlined in the Group Policy and in accordance with the Canadian Life and Health Association (CLHIA) guidelines.
  • Plan, implement and evaluate sound case management principles.
  • Responsible for the issuance of correct benefit payment.
  • Responsible for professional and accurate verbal and written communication with all stakeholders.
  • Manage assigned portfolio and become subject matter expert on assigned groups.
  • Communicate with other departments including Medical Underwriting, Group Underwriting, Sales, Group Administration, Accounting, etc. to provide and exchange information regarding claims activities, eligibility and financial transactions.
What you must have:
  • Experience and/or education related to disability claims management is preferred.
  • Knowledge of the insurance benefit industry is considered an asset.
  • Requires analytical skills, detail orientation and organizational skills.
  • Demonstrated excellence in the decision-making process especially when under pressure.
  • Strong team-player skills and cooperative attitude.
  • Excellent written and verbal communication skills.
  • Requires strength in the areas of flexibility, innovation and independence.
  • Must be able to deal effectively with the public, peers, and co-workers.
  • Knowledge of and experience with Microsoft Word and Excel will be an asset.
  • Enrollment in LOMA or other industry related courses would be an asset.
For more information about TEEMA and to consider other career opportunities, please visit our website at By applying to TEEMA on any job portal implies you are entering into a business relationship with us and therefore grants TEEMA consent to send you further job updates or industry and company-related information.

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