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Ability Case Manager

2 weeks ago

Cambridge, Canada Cambridge Memorial Hospital Full time

Overview:
Join a hospital where everyone makes a difference Cambridge Memorial Hospital (CMH) is a thriving community hospital that proudly provides acute care services including: Emergency, Surgery, Medicine, Women’s and Children’s Health, Intensive Care, Mental Health, and Inpatient Rehabilitation.

Our vision is to **_provide exceptional healthcare by exceptional people_**_._ Our dedicated and skilled staff are passionate about providing outstanding patient-centred care, and an exceptional patient experience to residents of the Waterloo Region and beyond.
- Healthcare of Ontario Pension Plan (HOOPP)
- Group Benefits, including Health & Dental, for full time employees
- Employee & Family Assistance Program
- Career Development & Education Grant
- Wellness & Wellbeing Program
- Diversity, Equity & Inclusion Initiatives

**Job Description**:
**Position Summary and Scope of Role**:
The Ability Case Manager (CM) provides strategic case management and integrated disability management of all cases of non-occupational illnesses or injuries including return to work programs at CMH. Management of Occupational illness and injuries may be required at times. The CM collaborates with internal and external resources to ensure successful and timely outcomes in each case. The CM is responsible for working with and assisting the Health Safety and Wellness and Wellness and Well-being teams to coordinate and support employee wellness activities and programs at the Hospital to support early and safe return to work.

***

**Primary Responsibilities**:

- Serve as the primary contact for all non
- occupational return to work programs, the CM will be responsible for non-occupational claim management and adjudication. This will include maintaining complete record, documentation and spreadsheets of each case file including return to work cases. Monitor and evaluate all medical documentation received and ensure appropriate tracking and reporting of claims, while submitting appropriate forms and documents as required within acceptable timeframes.
- In collaboration with the HSW coordinator, HSW Administrative Assistant and benefits and compensation specialist, develop and maintain effective working relationships with external agencies (i.e. WSIB, LTD provider, Human Resources Development Canada) while overseeing the early and safe return to work programs to meet legislative, collective bargaining and financial requirements. The CM will ensure that medical documentation is appropriate and will request additional medical information if required.
- Liaise with WSIB, LTD Case Managers and other stakeholders regarding claims during the return to work process.
- Receive and review Medical Evaluation Forms (MEF) and other medical documentation provided by employees (e.g. FAF’s), and based on review approve or deny short term sick leave benefits. If the MEF is not received or is not completed in full, and sick benefits are recommended to be denied, the CM will contact the manager, Human Resources, other stakeholders and employee to inform and follow up with the Physician if the employee provides consent to do so, and will also communicate any changes in payroll coding (i.e. sick paid, sick pending, sick unpaid). When criteria for sick leave are not met, the CM will inform the employee, manager, and Human Resources advisor for the purpose of planning Return to Work (RTW).
- The CM will determine suitability for an employee’s return to work and assist in identifying a suitable placement by coordinating RTW programs that include modified work (long term, short term, or permanent accommodations. This could include work redesign, task reconfiguration, or schedule adjustments). The CM will communicate with Managers, Occupational Health colleagues, HR, Payroll, Staffing Schedulers, Union, Directors, Physicians and other healthcare professionals including Physiotherapists, etc. and will coordinate meetings with all workplace parties (including union partners) to ensure the RTW is successful.
- The CM will refer staff for work station or work task analysis as required for ergonomic purposes to the HSW Ergonomist (OT).
- Collect, review and evaluate RTW evaluation forms in order to develop and implement initiatives for improvement, while evaluating the RTW programs including financial impacts and trends and recommend appropriate action, education and program implementation.
- In cases where the evidence supports the injured or medically unwell worker being capable of working and/or progressively toward regular duties, or when there are inconsistencies and/or disparity between the mechanism of injury and the resulting injury severity, the CM will engage HSW supports quickly to bring the matter to their attention.
- Implement disability management strategies to facilitate early return to work/prevention of lost time.
- Knowledge and understanding of the Provincial Central and Hospitals Local Collective Agreements.
- Knowledge and understandi