Wc Case Manager

2 months ago

Montréal, Canada Alight Full time

**Job Description - Senior Worker’s Compensation Case Manager**

Reporting to the Manager, Worker’s Compensation, the Senior Case Manager will be responsible for assisting employees on behalf of the employer when the employee is off work, or at risk of being off work, due to a workplace injury.

**Your responsibilities will include**:
Managing Worker’s Compensation claims:

- Claim files review and analysis;
- Identify and draft objection letters, if applicable;
- Identify, establish and monitor return to work strategies;
- Insure administrative and medical management of complex Worker’s Compensation claims management
- Maintain close communication with clients, CNESST and workers, with regards to Worker’s Compensation claims management;
- Identify and prepare files requesting Independent medical evaluation and proceed with medical arbitration requests;
- Identify and prepare appeals at various levels. Insure monitoring of appeals;
- Participate and coordinate the rehabilitation process of injured workers;
- Analyze and draft cost recovery requests;
- Prepare files for hearings and participate in the mediation process;
- Upon request, perform other tasks or participate in special projects.
- Meeting with clients to review internal workplace injury issues
- Managing workplace injury claims, minimizing time-loss and claim costs through early intervention and proactive co-ordination of services
- Ensuring regular and open lines of communication with clients, injured workers, and the provincial Workers’ Compensation Boards
- Liaising with the provincial Workers’ Compensation Boards
- Review claim files
- Interpreting provincial workers’ compensation legislation, policies and procedures
- Filing reports of injury, identifying appeal issues, drafting letters of objection
- Coordinating case management activities including developing, implementing and monitoring return to work and rehabilitation strategies
- Facilitating 3rd party interventions (functional capacity evaluations, independent medical evaluations)

**Qualifications**:

- Education in a related field;
- Minimum of three (3) years of work experience in a worker’s compensation claims management capacity;
- Good understanding of the management of workplace injuries as well as knowledge of the applicable laws;
- Excellent proficiency of the French language both written and spoken. Good knowledge of the English language both written and spoken;
- Proficient MS Office (Word, Excel, PowerPoint and Outlook);
- Acute sense of customer service;
- Management of priorities and timelines;
- Ability to work under pressure with professionalism;
- Strong interpersonal skills, helping relationships, and a problem-solving analytical mindset.
- Work experience in a workers’ compensation claims management capacity either at the CNESST (or a similar provincial workers’ compensation board-commission) or in an in-house capacity at a private company with corresponding knowledge of workers’ compensation statutes, policies and procedures, and workplace health and safety would be an asset
- Familiarity with Microsoft Word, Excel, and Outlook
- Must be bilingual (French and English)

Relevant du gestionnaire d’indemnisation des accidents du travail, le gestionnaire des cas d’indemnisation des accidents du travail est responsable, au nom de l’employeur, de fournir une assistance aux employés qui sont en arrêt de travail ou qui risquent de l’être en raison d’un accident du travail. Le rôle consiste à évaluer les obstacles à un retour au travail réussi et rapide et à mobiliser les parties prenantes pour mettre en œuvre des stratégies visant à éliminer les obstacles identifiés et à soutenir le retour au travail ou un autre plan d’action approprié.

**Principales responsabilités**:

- Rencontrer les clients pour passer en revue les problèmes internes d’accidents du travail.
- Gérer les demandes d’indemnisation pour accident du travail, minimiser les pertes de temps et les coûts des demandes d’indemnisation grâce à une intervention précoce et à une coordination proactive des services.
- Assurer des voies de communication régulières et ouvertes avec les clients, les travailleurs accidentés et les commissions provinciales

des accidents du travail.
- Assurer la liaison avec les commissions provinciales des accidents du travail.
- Examiner les dossiers de réclamation.
- Interpréter les lois, les politiques et les procédures provinciales en matière d’indemnisation des accidents du travail.
- Soumettre des rapports de blessure, déterminer les problèmes en matière d’appel, rédiger des avis d’opposition.
- Coordonner les activités de gestion de cas, y compris l’élaboration, la mise en œuvre et le suivi des stratégies de retour au travail et de réhabilitation.
- Faciliter les interventions de tiers (les évaluations des capacités fonctionnelles, les évaluations médicales indépendantes).

**Compétence

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