Disability Case Management Quality Analyst

at  Sun Life

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You’ll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you’ll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

PREFERRED SKILLS

• Must have Long Term Disability Claims Management experience 3-5 years
• Experience in auditing, sampling and reconciliation
• Knowledge of Organizational Effectiveness, Group Benefits and understanding of GB strategy
• Knowledge of other Group Benefits areas

QUALIFICATIONS

• 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)
• As this position is posted in several locations, we specify that bilingualism (French, English, both oral and written) is required for Quebec only for the frequent interactions with English and French-speaking colleagues or internal partners across Canada or worldwide.
• PC knowledge (Windows XP, Excel, Word)
• Strong verbal and written communication skills
• Demonstrate a collaborative and interactive style that initiates and facilitates discussion within the team and with our business partners
• Strong analytical, organizational and problem solving skills
• Grasps new concepts quickly and is able to explain them
• Attention to detail
• Ability to work independently within scheduled deadlines
• Ability to prioritize work
• Ability to make timely and sound decisions
• Strong customer focus

PLEASE NOTE THIS ROLE IS HYBRID.

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.

WHAT WILL YOU DO?

• 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