We are seeking a Disability Management Specialist to join our Organizational Solutions team (OSI).

The Disability Management Specialist is responsible for overseeing the full lifecycle of disability management claims including complex files. You will conduct a detailed functional assessment, review medical and workplace documentation, adjudicate claims in accordance with organizational and client policies, and initial consideration of the return to work on every claim.

Additionally, you will maintain accurate and timely documentation within the Internal Claims Management System, along with ensuring all claim activities, communication, and next steps are clearly documented and communicated to the client.

The Disability Management Specialist will ensure early and secure return to work through the development and monitoring of individualized recovery and transitional return to work plans. This includes collaborating with healthcare providers, other key support service partners and health providers, and employers (clients), to optimize treatment and workplace accommodations.

The Disability Management Specialist will also provide guidance and support to other Recovery Facilitators by sharing expertise, assisting with complex claim decisions, and promoting consistency in client-specific processes and protocols.

The Disability Management Specialist will:

- Manage all non-complex and complex claims including but not limited to psychological claims, multiple diagnosis, and co-morbid conditions
- Conduct detailed phone functional interviews regarding activities of daily living (ADL) while providing tips to reduce barriers
- Evaluate medical and workplace information to determine if key elements are present
- Adjudicate of all claims in accordance with client and OSI policies, and with a high degree of excellence




- Request clinical notes in any claim that requires additional clarity including, mental health claims with pre-existing documentation, identified workplace concerns, unique circumstances, etc.
- Enter detailed info regarding the claim, status, communications, and next steps, into the Internal Claims Management System
- Ensure a Care Management Action Plan is in place on all files, as required
- Manage all claims with a return to work (RTW) focus and for the lowest duration possible and with a continuous improvement impact
- Produce appropriate tools to communicate status of claim to clients and claimants (varies based on client)
- Develop outcome focused recovery and return to work plans with facilitation of return to work as soon as possible
- Determine when additional tools are to be used at the appropriate times (i.e.: IME / FCE, refer to rehabilitation, medical consultant, pharmacogenetics, cognability, or workstation evaluations etc.)
- Interact with various key support service partners, health providers, to enhance claim outcomes, facilitate treatment plans, and ensure the claimant is receiving optimal treatment at all times
- Be aware of status on claims at all times, ensuring Internal Claims Management System is fully updated
- Communicate the employee's functional capabilities to the employer to determine if the employer is able to provide modified duties in the return to work planning




- Facilitate return to work consistently with a Transitional Return to Work Plans (TRTWP)
- Monitor the progressive Transitional Return to Work Plans
- Follow up with any missing claim actions or information
- Complete file reviews with Team Lead on any claims over 30 days
- Complete midpoint review with designated team members
- Ensure reported comments updated within the designated time frame
- Close claim in the Internal Claims Management System once claimant has returned to work
- Act as the primary contact on assigned adhoc claims
- Record all billable and non-billable time in the Internal Claims Management
- Work with client(s) to understand workplace philosophy and job demands
- Participate in monthly client calls and meetings as required
- Update any monthly reports, as required
- Work collaboratively as part of client(s) team both internally and externally
- Coach and mentor other disability management staff by enhancing their knowledge and education levels
- Provide support to other Recovery Facilitators and guidance on client(s) specifics and decision process and protocol

To be Successful as the Disability Management Specialist, you will need:

- The ability to plan - set objectives and determine strategy to achieve them
- A strong sense of urgency and organization / prioritization skills
- To identify problems and develop effective solutions quickly
- To work with great accuracy and attention to detail
- Critical thinking skills, analytical reasoning, strong negotiation skills and conflict resolution skills
- Excellent customer service and communication skills
- The ability to work within set procedures and policies to ensure the privacy protocols and standard operating procedures are adhered to at all times
- The ability to meet and exceed

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📌 Disability Management Specialist (Burlington)
🏢 Peoplecorporation
📍 Burlington