Case Manager - Life & Disability Operations

Alberta Blue Cross • Edmonton, AB

8d • Hybrid

About The Position

Alberta Blue Cross® is an Alberta based organization dedicated to delivering exceptional customer experience and community leadership. They are committed to providing the best health coverage to over 1.8 million members and take an active role in promoting wellness. They believe in what they do and place trust in their employees to deliver their vision. Working at Alberta Blue Cross® means having a career where contributions are recognized. They value diversity, encourage team members to maintain a healthy work-life balance, and provide opportunities for career growth. The organization is continuing to grow its team and is looking for additional Case Managers. Working in a flexible work style arrangement, Case Managers are responsible for managing Short-Term Disability and Long-Term Disability claims. This includes managing the initial decision making on the claim as well as ongoing management, developing and monitoring treatment plans, return to work planning, and rehabilitation programs. As a Case Manager, you will develop relationships with involved parties and provide expert advice to internal and external customers on a daily basis.

Requirements

• Strong 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.
• Proven strength in the areas of flexibility, innovation and independence.
• Ability to deal effectively with external stakeholders and coworkers.
• Proficiency with Microsoft Word and Excel is required.

Nice To Haves

• Degree or diploma in a health-related field such as in Nursing, Kinesiology, Rehabilitation Medicine or Social Work.
• Experience related to disability claims management.
• Mental Health claims management experience.
• Knowledge of the insurance benefit industry.
• Certified Disability Management Professional (CDMP).
• Enrollment in LOMA or other industry related courses.

Responsibilities

• 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 Alberta Blue Cross® departments including Medical Underwriting, Group Underwriting, Sales, Group Administration, and Accounting to provide and exchange information regarding claims activities, eligibility and financial transactions.

Benefits

• Value diversity, encourage team members to maintain a healthy work-life balance and provide opportunities for career growth.
• Opportunity to work in an innovative, high-energy team-focused environment.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 501-1,000 employees