Disability Claims Management (Intake and Early Intervention Program)
If you are a skilled disability case management professional who has experience working in a fast-paced environment with individuals who are ill or injured regain their health and return to work, then this could be the job for you!
Utilizing a proactive disability management approach, this role assists individuals address their health issues early in the onset of illness or injury with a goal to support them to remain at work with modified hours/duties or to return to work within the elimination period or guide them during the Extended Disability Benefit (EDB) application process, if required. This role builds relationships with covered members during their sick leave period and collaborates with health care providers, their employer, the covered member, and their representatives to ensure a supported return to work plan is in place. This position also includes Early Intervention Program (EIP) eligibility decision making, proactive case management, coordination of medical assessments and treatment; requests for medical information; expedited treatment; and coordination and funding of treatments, as required.
Your Key Responsibilities
- Build early relationships with covered members and assist with coordination of treatment in conjunction with their health care providers with the goal to facilitate recovery and return to work.
- Coordinate communication with the covered member, health care providers and employer to assess anticipated recovery time, develop an action plan in support of modified work hours or gradual return to full-time equivalent, and to modify the plan as needed.
- Follow-up regularly with covered members to monitor their recovery status and assess their perception of health to foster a shared understanding of progress and next steps.
- Assess the claim application for eligibility to participate in the EIP program.
- Adjudicate decisions regarding eligibility for EIP and rehabilitation programs.
- Monitor the success of the modified/gradual return to work plan and make adjustments as needed.
- Coordinate referrals for medical assessments and/or functional capacity evaluations to assist in confirming diagnosis, treatment needs and/or adjudication of the EDB application, as required.
- Liaise with the employer regularly to keep them updated on the covered member's status during the elimination period and/or EDB application, as required.
- Liaise with employer regarding individuals with short-term health issues; provide advice to ensure that the health issues are addressed with appropriate resources and creative options and strategies in the workplace are implemented to support the individual's ability to remain at work.
- Coordinate the initial adjudication of EDB applications.
- Apply a holistic approach to the case management and adjudication process, considering individual needs of the client and the employer.
- Effectively communicate and manage the results of difficult or adverse decisions.
- Link covered members to appropriate community resources and ensure they are aware of their benefit coverage.
Your Education and Experience
- Two to five years of health experience in disability case management within WCB, an insurance company and/or employer environment, proactive case management or equivalent clinical work.
- Health-related degree or diploma in disability management or equivalent is preferred.
A combination of education and experience may be considered.
- A supportive approach that considers the "whole person" rather than a narrower medical management approach, while remaining focused on proactive case management.
- Exceptional organizational skills with an ability to prioritize work and manage a busy caseload with ease and efficiency.
- Highly skilled communication skills with the ability to clearly explain EIS services and programs as well as complex information, as required.
- A collaborative and integrated approach to work, with a demonstrated ability to work as part of a team to best serve our covered members and employers.
- A positive perspective and flexibility to deal with complex and challenging situations that arise.
- A creative approach to solving issues and resolving barriers that are preventing individuals from remaining at work and/or returning to work.
- Experienced working in a fast-paced environment with short deadlines.
Unique Working Conditions
You will be working with groups across the province, so some travel may be required in this role. This position is eligible to participate in the hybrid workforce program.
How To Apply
If you have the required qualifications and would like to become a member of our team, please submit your resume by 4PM on Monday, June 19, 2023.
No phone calls please. We thank all interested individuals, but only those candidates being considered for an interview will be contacted. ASEBP is an equal opportunity employer.
All offers of employment for this position are conditional upon satisfactory background and reference checks, which may include a criminal record check, and/or education and employment verification.