Disability Claims - Quality Analyst

Sun Life • Waterloo, ON

1d • CA$58,000 - CA$93,000 • Hybrid

About The Position

This is a one year opportunity. The Quality Analyst position is part of a team whose mandate is to conduct independent and objective quality assessments of Disability claims files. The team’s focus is to ensure that operational processes and practices are consistent with best practices established on a national basis. The Quality Analyst will complete audit functions on the lifecycle of a disability claim, including Short-Term Disability, Long-Term Disability and Health Management Consulting, including the assessment of the claims decision processes. The ability to learn and apply key concepts across all programs (i.e. Creditor, Compliance, Case Management Quality, Association and Affinity, Waiver, Plan Sponsor Agreement etc.) will be required.

Requirements

• Must have Long Term Disability Claims Management experience 3-5 years
• Must have minimum of 3 years of experience as a Disability Case Manager
• Experience in auditing, sampling and reconciliation
• Knowledge of Organizational Effectiveness, Group Benefits and understanding of GB strategy
• Knowledge of other Group Benefits areas
• In-depth level of knowledge of disability claims (STD, LTD, and Health Management) processes, controls and systems (3-5 years of long term disability claims experience)
• PC knowledge (Windows XP, Excel, Word)
• Bilingualism (French, English, both oral and written) is required for Quebec only

Responsibilities

• Conduct quality reviews focusing on case management principles as well as overall case management excellence of assigned disability claims files; record quality assurance results using audit tools
• Review new claim decisions and/or change of definition decisions to assure the quality of the decision as defined by our contract, philosophy and practices
• Meet service levels for quality, quantity and timeliness (individual and team)
• Provide feedback on evaluation along with suggestions of improvement
• Remain current on Group Life and Disability practices and processes
• Provide input on trends to support actionable recommendations for quality improvement
• Participate in calibration sessions to ensure consistency in the application of the measures and to ensure program objectives are met
• Provide subject matter expertise input into Disability process related inquiries
• Provide feedback on the assessment with strong supporting rationale, when there is a disagreement between Quality and Operation

Benefits

• Access to short-term assignments or ‘Gigs’ across the organization, to help you develop new skills and connections.
• A collaborative and interactive team environment
• Charitable giving through our You Give, We Give program lets you give back to your community – and in many cases, we’ll match your contributions.
• Care Days available for self-care or care of others (i.e., family or others you may support) and Sick Days to support your well-being.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed