Disability Case Manager

Disability Management Institute (DMI) offers small and medium sized employers flexible innovative solutions to their disability management needs. Our specialties include: WCB/WSIB Claims Management, Self-Funded Sick Leave Adjudication, and Non Occupational Absence Management, Return to Work Planning, Disability Management, and STD, MTD, and LTD Claims Management. Ranging in size from 5-2500 employees our clients span the public and private sectors and cover a wide range of industries    YOUR ROLE   We are currently seeking a qualified candidate to fill an Disability Case Manager. The Disability Case Manager (Employer Services) will be responsible for providing a high caliber of Advice to Pay claims management services to a broad customer and client base within the Employer marketplace. This will be accomplished through the development and implementation of pro-active case adjudication and management principles within timely and cost-effective strategic tools and resources.   WHAT TO EXPECT  

Within 30 Days you will:

• Completes a full and thorough employer initial call and document accordingly within designated system platform
• Completes a full and thorough employee initial call and assesses whether a file meets criteria (policy specific) and document accordingly within designated system platform
• Identifies influencing factors that would suggest a complex file, and with support develops and maintains an appropriate case management plan.
• Continuous QC from ES Manager prior to rendering claim recommendation/decision
• Demonstrate full understanding of applicable privacy legislation and provides client updates that are consistent with legislative and contractual requirements.

Within 60 Days you will:

• Possesses a full understanding of all DMI programs and services and identifies files that meet criteria for referral
• Identifies influencing factors that would suggest a complex file, and with support develops and maintains an appropriate case management plan.
• Independently adjudicates, creates and monitors case management plans for straight-forward cases
• Creates, implements and monitors RTW plans
• Ongoing ES Manager QC oversight

Within 90 Days you will:

• Adjudicates and manages files from referral to resolution with minimal oversight
• Ongoing QC review for complex and long duration claims; level of QC monitoring to be determined (based on above)
• Effectively manages a full caseload of files

YOUR IMPACT

• Assess short-term disability claims for benefit eligibility and render decisions within service standards. Assessment includes evaluation of medical information, occupational and contractual provisions and if necessary, pursuit of additional information.
• Conduct telephone interviews, with a focus on obtaining pertinent, medical/treatment status, functional information and RTW readiness.
• Identify and evaluate medical and non-medical barriers and functional abilities, to positively impact outcomes.
• Develop, communicate and implement pro-active case management plans.
• Collaborate, negotiate and develop RTW plans.
• Identify suitable rehabilitation referrals (as required), in keeping with Employer disability and absence policies and costing.
• Utilize external and internal resources, as necessary, to progress files forward to resolution, with a focus on function and gainful employment. Collaborate with healthcare providers/physicians, written or verbal, based on needs of the claim.
• Manage external referrals, services and relationships with service providers and strategic partners through research and knowledge of local community resources. Understanding of employer specific resources (i.e. EFAP) and coordination of the same.
• Demonstrate an understanding of various rehabilitation and or vocational tools that may be applied in effort to move toward resolution.
• Serve as an expert claims management resource for customers and the internal business units.
• Engage in professional interaction with all stakeholders on a regular basis, including timely and efficient follow up to telephone and email communication.
• Provide timely, detailed documentation to ensure progression and fulfillment of case management plans.

THIS IS YOU

• Related Post Secondary Degree (i.e. Kinesiology, Psychology, Social Work or related discipline) or equivalent experience.
• Bilingual in French is an asset.
• Solid background and knowledge of STD policy and coverage. Understanding of LTD and Group plans an asset.
• Strong analytical skills, excellent problem-solving abilities and can work with minimum of supervision.
• Professional communication skills, oral and written, and ability to adapt communication style for a range of stakeholder and client needs.

WHAT YOU'LL GET   In addition to becoming part of a creative, challenging, and stimulating work environment, we also offer:

• Comprehensive and competitive benefits package that supports you
• Our company-wide vacation policy guarantees a minimum of 3 weeks' vacation
• Flex days to help you achieve that work-life balance
• Wellness programs to support you in and out of the office
• Learn and grow with us through our employee education program
• Participation in our Happy Friday program

YOUR COMPENSATION

At the time of this posting, the estimated annual base salary pay range for this position is $60,000-$70,000. Individual compensation within this range is determined by factors such as job-related skills, relevant experience, and education/training. This range reflects the annual base salary only pay and does not encompass our comprehensive total rewards, benefits, and potential bonuses that we proudly offer. 

We thank everyone who applies to the Disability Case Manager role; however, due to the volume of applications we receive, we are only able to contact candidates who have been selected for an interview.

 

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