Overview
Quality Analyst Jobs in Waterloo, Ontario, Canada at Sun Life
Job Description
:
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
What do you need to succeed?
Must have Long Term Disability Claims Management experience 3-5 years
Must have minimum of 3 years of experience as a Disability Case Manager
Experience in auditing, sampling and reconciliation
Knowledge of Organizational Effectiveness, Group Benefits and understanding of GB strategy
Knowledge of other Group Benefits areas
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)
PC knowledge (Windows XP, Excel, Word)
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.
What’s in it for you?
The opportunity to move along a variety of career paths with amazing networking potential
Flexible Benefits from the day you join to meet the needs of you and your family
We’re committed to creating an inclusive and respectful environment. Our goal is to make sure all our employees have the chance to live up to their full potential
We’re honoured to be recognized as a 2024 Best Workplaces in Ontario by Great Place to Work® Canada
We are thrilled to be recognized by Excellence Canada with their top-level certification, the Canada Order of Excellence for Mental Health at Work®, for prioritizing employee well-being, fostering a positive work culture, and achieving excellence in mental health
Title: Quality Analyst
Company: Sun Life
Location: Waterloo, Ontario, Canada
Category: Quality Assurance – QA/QC (Data Analyst), Healthcare
