Manager Claims Risk Management

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

The Claims Risk Management team is responsible for establishing best practices for claims handling as well creating and delivering training across all product lines. The team provides guidance to Claims departments in Individual, Fixed Wealth, GRS and Group Insurance on highly complex or litigated claims. They are the key contacts in claims with the reinsurers. The team is headed by the Director, Claims Risk Management who reports to the Chief Underwriter and Claims Risk Officer.

The manager will assist with back up and support for the Director, Claims Risk Management role and will also support the director in reviewing and assessing complex claims, conducting claims reviews, analyzing auto-decision failures with a goal of increasing acceptance rate. This role will support the documentation of claims philosophies and guidelines. The Manager, Claims Risk Management role will assist the Director in providing claims expertise with internal and external parties including Product, Underwriting, Legal, Reinsurers and Investigators.

The Manager, Claims Risk Management leads the development, implementation and deployment of effective claims best practices. The Manager ensures consistency between locations and provides formal mentorship to the claims operations managers by driving change and developing recommendations that reflect the needs of clients, advisors, plan sponsors and beneficiaries. The manager maintains a close working relationship with the management of Claims Operations and Best Practices across all Canadian lines of business within the Claims Centre of Excellence.

This role is appropriate for a senior professional with a deep and thorough understanding of Life Insurance and Living Benefits.

What will you do?

Key Auto-Decision Accountabilities:

• Lead the analysis of auto-decision failures with the primary goal of increasing the acceptance rate

• Conduct regular reviews of auto-decision rules and provide comprehensive reports to re-insurers and corporate Risk Management partners

• Ensure auto-decision claims practices are being followed and decisions are being made as expected

• Identify and implement opportunities to improve auto-decision processes for enhanced client experience and operational efficiencies

Other Responsibilities:

• Identify opportunities to improve claims practices from a client experience and efficiencies perspective

• Provide consultation on escalated, complex and litigated claims

• Back-up the Director, Claims Risk Management for key compliance and reinsurance reporting

What do you need to succeed?

Knowledge:

• Expert knowledge of Life Claims and Living benefits that are part of the claims centre of excellence

• In-depth knowledge of legal and regulatory issues for claims

• Proficient knowledge of medical terminology, anatomy and physiology

Competencies:

• 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.

• Communication - presents information in a clear and concise manner

• Independence - ability to navigate effectively within a large organization

• Influence and Impact - must be able to negotiate claims settlements

• Building Relationships - ability to work well with people at various levels through building relationships in order to achieve results

• Drive for Performance - ability to manage multiple tasks and prioritize effectively, while working well under pressure to meet requirements

• Problem Solving and Analytical skills- ability to analyze and resolve complex issues

• Strong Customer Service Skills - ability to handle escalated cases

Unique Requirements:

Education and Experience:

• Educational Requirement: Bachelor's degree or Industry related courses ACS or ALHC

• Minimum 5-10 years of claims and living benefits operations business knowledge

Assets:

• Bilingual, written and oral French and English

What’s in it for you?

• Flexible Benefits from the day you join to meet the needs of you and your family.

• Pension, stock and savings programs to help build and enhance your future financial security.

• Wellness programs that support the three pillars of your health - mental, physical and financial.

• Being a member of the Sun Life family, a group of people united by our Purpose: to help Clients and Employees achieve lifetime financial security and live healthier lives.

The Base Pay range is for the primary location for which the job is posted. It may vary depending on the work location of the successful candidate or other factors. In addition to Base Pay, eligible Sun Life employees participate in various incentive plans, payment under which is discretionary and subject to individual and company performance. Certain sales focused roles have sales incentive plans based on individual or group sales results.

Diversity and inclusion have always been at the core of our values at Sun Life. A diverse workforce with wide perspectives and creative ideas benefits our clients, the communities where we operate and all of us as colleagues. We welcome applications from qualified individuals from all backgrounds.

Persons with disabilities who need accommodation in the application process or those needing job postings in an alternative format may e-mail a request to thebrightside@sunlife.com.

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

We thank all applicants for showing an interest in this position. Only those selected for an interview will be contacted.

Salary Range:

Job Category:

Posting End Date: