案例经理 – 生命与残疾服务
Case Manager – Life & Disability Services
阿尔伯塔蓝十字公司® 是一家位于阿尔伯塔的组织，致力于提供卓越的客户体验和社区领导力。我们致力于为超过180万会员提供最佳健康保障，并积极促进健康。我们相信我们的工作——并信任员工来实现我们的愿景。
在阿尔伯塔蓝十字公司® 工作意味着拥有一份会得到认可的职业。我们重视多样性，鼓励团队成员保持健康的工作与生活平衡，并提供职业发展的机会。
简介：
我们正在继续扩大团队，寻找更多的案例经理。在灵活的工作安排下，我们的案例经理负责管理短期残疾和长期残疾索赔。您将负责索赔的初步决策以及持续管理，包括制定和监控治疗计划、返岗计划和康复项目。作为案例经理，您将与相关方建立关系，并每天向内部和外部客户提供专业建议。
您将负责：
- 处理短期残疾和长期残疾索赔。
- 确保按照团体政策和加拿大人寿与健康协会（CLHIA）指南正确应用规则和法规。
- 计划、实施和评估有效的案例管理原则。
- 负责正确发放福利支付。
- 负责与所有利益相关者进行专业且准确的口头和书面沟通。
- 管理分配的组合，并成为所分配群体的专家。
- 与其他阿尔伯塔蓝十字公司® 部门沟通，包括医疗核保、团体核保、销售、团体行政和会计，以提供和交换有关索赔活动、资格和财务交易的信息。
您将具备：
- 健康相关领域的学位或文凭，如护理、运动科学、康复医学或社会工作，是加分项。
- 与残疾索赔管理相关的经验。
- 具有心理健康索赔管理经验是加分项。
- 对保险福利行业有了解是加分项。
- 强大的分析能力、注重细节和组织能力。
- 在压力下具有出色的决策能力。
查看英文原文
Alberta Blue Cross® is an Alberta based organization dedicated to delivering exceptional customer experience and community leadership. We’re committed to providing the best health coverage to over 1.8 million members and take an active role in promoting wellness. We believe in what we do—and place trust in our employees to deliver our vision.
Working at Alberta Blue Cross® means having a career where you’ll be recognized for your contributions. We value diversity, encourage our team members to maintain a healthy work-life balance and provide opportunities for career growth.
OVERVIEW:
We are continuing to grow our team and are looking for additional Case Managers. Working in a flexible work style arrangement, our Case Managers are responsible for managing Short-Term Disability and Long-Term Disability claims. You will manage the initial decision making on the claim as well as ongoing management including developing and monitoring treatment plans, return to work planning and rehabilitation programs. As a Case Manager, you will develop relationships with involved parties and provides expert advice to internal and external customers on a daily basis.
WHAT YOU WILL DO:
- 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.
WHAT YOU WILL HAVE:
- Degree or diploma in a health-related field such as in Nursing, Kinesiology, Rehabilitation Medicine or Social Work is an asset.
- Experience related to disability claims management.
- Mental Health claims management experience is considered an asset.
- Knowledge of the insurance benefit industry is considered an asset.
- 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.
- Certified Disability Management Professional (CDMP) would be an asset.
- Enrollment in LOMA or other industry related courses would be an asset.
This position will remain open until suitable candidates are selected.
Alberta Blue Cross® is an inclusive employer committed to a workplace that reflects the diversity of the communities we serve. We empower and are advocates for our team members by welcoming, respecting and valuing their unique perspectives, backgrounds, and experiences.
We offer the opportunity to work in an innovative, high-energy team-focused environment. If you have the qualifications we are looking for, apply online at
A criminal record check satisfactory to Alberta Blue Cross will be required as a condition of employment, following a conditional offer.
Originally posted on Himalayas