Healthcare Case Manager

4 days ago


Newmarket, Ontario, Canada Njoyn Full time
Job Overview

The Abilities Case Specialist is a critical role within the Occupational Health, Safety & Wellness team at Southlake. This position is responsible for managing employee work-related and non-work-related disability claims, ensuring compliance with Workplace Safety and Insurance Board (WSIB) legislation and the Hospitals of Ontario Disability Insurance Plan (HOODIP). The successful candidate will be responsible for adjudicating benefits, coordinating modified transitional return to work plans, and temporary and permanent workplace accommodations.

Key Responsibilities
  1. Manage employee disability claims, including short and long-term claims
  2. Proactively support employees to maintain their ability to remain at work
  3. Coordinate return to work process, ensuring seamless transition
  4. Review medical documentation and adjudicate benefits
  5. Document and maintain Employee Chart/ Claim file records
  6. Participate in appeals, grievances, arbitrations, and legal proceedings as required
  7. Coordinate temporary and permanent accommodations
  8. Attend return to work committee and other relevant meetings
Qualifications
  1. Baccalaureate degree in nursing, occupational therapy, physiotherapy, or other health-related science discipline
  2. Minimum three years disability claims management experience
  3. Experience in a unionized environment, preferably in healthcare setting
  4. Registration with relevant college and membership in professional association preferred
  5. Working knowledge of relevant legislation, e.g., Human Rights Code of Ontario, Occupational Health & Safety Act, Workplace Safety Insurance Act
  6. Conflict resolution and negotiation skills
  7. Demonstrates excellence in communication skills, both written and verbal
  8. Ability to effectively problem solve and adapt to change management

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