Team Leader, Quality Services

🔥 16 hours ago

🇨🇦 Canada – Remote

💵 $88.2k - $99.2k / year

⏰ Full Time

🟠 Senior

👻 Ghost score 0%

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Medavie

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance • Community Health

Medavie is a national health solutions partner dedicated to improving the wellbeing of all Canadians. It integrates benefits management, healthcare delivery, and advanced health solutions, aiming to transform healthcare in Canada with innovative approaches. Medavie also focuses on community health through its foundation, promoting initiatives for accessible and equitable healthcare services.

📋 Description

• Lead the Life & Critical Illness Claims team and Appeals team • Provide day-to-day leadership, coaching, guidance, and technical expertise to adjudicators and Appeals specialists • Support complex, sensitive, or precedent-setting claims • Ensure Appeals reviews are objective, consistent, timely, and within service standards • Oversee workload distribution, case prioritization, and team performance • Interpret Life, Critical Illness, and Disability contracts • Review complex or escalated cases and provide recommendations or direction • Ensure decisions are well-reasoned, documented, and aligned with policy wording and best practices • Identify decision-making trends and coach employees to improve adjudication quality • Enhance claims processes, workflows, and decision-making tools • Collaborate with Operations, Medical, Legal, and other internal partners on guidelines and procedures • Develop and maintain training materials, job aids, and reference documents • Participate in system and process enhancement initiatives • Prepare reports on team performance, Appeals outcomes, trends, and emerging issues • Communicate updates, risks, and recommendations to leadership • Set goals, conduct performance reviews, and develop action plans • Foster a collaborative, supportive, and high-performance team culture

🎯 Requirements

• Post-secondary university or college degree • Minimum 5 years previous experience in Life, CI and/or Disability Claims • 10 years of experience in the insurance industry (Life and Disability) • 1 year in a supervisory capacity in Life and Disability Case Management • Strong understanding of adjudication and Appeals processes • Demonstrated leadership with the ability to coach, support team performance, and drive high engagement effectively • Excellent communication skills • Strong analytical and decision-making skills • Ability to manage competing priorities • Deep understanding of contract wording and claims practices • Bilingualism in French and English • English proficiency required for daily collaboration with teams and partners outside Québec

🏖️ Benefits

• Health and dental coverage that is 100% employer paid from day one • Wellness benefits • Health resources • Fitness center discounts • Flexible work environment supporting work–life balance • Professional development opportunities, including leadership programs and ongoing learning • Career growth pathways • Collaborative and inclusive culture • Performance-based incentive programs for eligible employees

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