Quality Audit - Toronto, Canada - Manion Wilkins & Associates

Manion Wilkins & Associates
Manion Wilkins & Associates
Verified Company
Toronto, Canada

2 weeks ago

Sophia Lee

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Sophia Lee

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Description

WHO ARE WE?
We're Manion, a Canadian firm that provides third party benefits administration, payments, and consulting services.

Providing solutions to streamline the administration of an organization's pensions and health benefits, they know how to deliver the highest value.

Manion leads the way in web-based plan access and administration, making it possible for Canadians to live healthy lives.


YOUR ROLE
This positon is hybrid coming into office two times a month or on as needed basis.

As a Quality Audit and Training Specialist you will:


  • Carry outstrategic case reviews and audits, identifying trends and opportunities.
  • You will identify trends and opportunities to drive quality performance aligned with best practices within the department and achieve corporate goals for the organization.
  • You will provide training, creating training programs, identifying trends and opportunities, and working with the Supervisor and Manager to develop strategies to
support the Disability Claims Administrators, Life Claim Specialist, Disability Case Managers, and Rehab Coordinator.

  • You will also include claim support initiatives and activities such as, but not limited to, project work (ex. Project Perspective), coaching new hires in their ongoing
development, task support etc., as needed to support the business


WHAT TO EXPECT
Within 90 days

  • Meet with Disability Leadership Team and all disability roles to gain an understanding of past and current coaching initiatives, processes, and ensure solid understanding of the TPA business, Union self insured plans, insured services paid and managed by MWA, and the Manion way of business.
  • Complete strategic file reviews of the claims team to gain an understanding of processes and insight into current claims management practices and competency levels of team
  • Review existing Quality Control and Quality Assurance initiatives that have been implemented/started and in conjunction with Disability Leadership Team and start to
develop and outline a plan for all business units with respect to:

  • Claims support activity needs
  • Opportunity File review
  • Training needs
  • Gain an understanding of existing metrics reporting for Disability Department and seek to incorporate benchmarks and performance into quality programs, as driven by service level requirements (TATs, recoveries, approval/decline rates, terminations, durations and costs, QAs, documentation practices etc)
  • Review, learn, and update all training material and process documents.

Create New Hire Training platforms for:

  • Disability Claims Administrators
  • Disability Case Manager
  • Life & Disability Claim Specialist
  • Rehab Services.
  • Meet with all roles to gain an understanding of past and current coaching initiatives, processes, and ensure solid understanding of the business and insight into
- current claims administration and management practices.

  • Determine where training can assist with ongoing learning

YOUR IMPACT

  • Conduct indepth quality assurance reviews & audits on claims administration, Life and Disability Specialist, STD & LTD claims, rehab files while assessing trends as well as areas of strength and development
  • Identify and report disability management trends or risks.
  • Development and implementation of claims resolution and transformation projects including leading strategy surrounding industry best practice philosophies related to that of a wholistic model.
  • Provide project management and stewardship in the development and management of policies and projects.
  • Work with management to identify training needs and schedule training programs for all staff including new employees onboarding.
  • Provide online and conference call training session for new hire remote employees
  • Participate in, or lead assigned specials projects, given other responsibilities and the evolving needs of the company, at the discretion of the Disability Leaders

THIS IS YOU

  • 710 years proven Disability Management experience.
  • Experience in developing & Delivery of training and audit material.
  • Background and knowledge of STD/LTD policy and coverage
  • Have previous experience in conducting quality audits for an insurer or equivalent in experience, training, and transferable skills.
  • Deep knowledge of claims: policy, eligibility, and entitlement; demonstrated through prior experience in this field.
  • A high attention to detail and solid analytical skills to come up with targeted proactive plans to assist in finalizing claims

WHAT YOU'LL GET

  • Comfortable compensation
  • Flexible office arrangements
  • Free onsite parking
  • Wellness and Fitness programs
  • Registered pension plan, and Group RRSP and TFSA
  • Flexible group benefits (we ARE good at this)
  • Opportunity for career development

WHY YOU WILL LOVE WORKING FOR MANION
We have a very strong family-oriented culture. Our work is meaningful, connecting people to healthier lives. The biggest reason we love coming to work is that we love wo
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