[Hiring] Senior Workers Compensation Case Manager @Alight

Role Description

The Senior Workers’ Compensation Case Manager is responsible for managing complex and long-duration workers’ compensation claims, with a focus on achieving timely, sustainable return-to-work outcomes while minimizing time loss and claim costs. This role serves as a subject matter expert in provincial workers’ compensation legislation, policies, procedures, and Workers’ Compensation Board (WCB) practices. The Senior Case Manager assesses barriers to successful return to work, critically analyzes WCB decisions, and partners with clients, injured workers, WCB representatives, healthcare providers, and other stakeholders to develop and implement appropriate case management, rehabilitation, and return-to-work strategies.

Responsibilities

• Managing complex, long-term and workplace injury claims, ensuring a clear path toward rehabilitation, reintegration, return to work, or an appropriate alternative plan.
• Assessing medical, functional, workplace, and other barriers that may impact a successful and timely return to work and develop strategies to address identified barriers.
• Developing, implementing, coordinating, and monitoring return-to-work and rehabilitation strategies in collaboration with clients, injured workers, WCBs, healthcare providers, and other stakeholders.
• Liaising directly with provincial WCBs regarding claim management, adjudication, return-to-work planning, and claim resolution.
• Interpreting and applying provincial workers’ compensation legislation, policies, procedures, and practices to effectively manage claims and proactively pursue resolution or closure.
• Conducting critical reviews of WCB decisions to assess alignment with applicable legislation, policies, and procedures. Identifying potential appeal or objection issues, draft letters of objection, and support or pursue appropriate appeal strategies.
• Identifying and pursuing cost mitigation opportunities, including cost relief and other applicable strategies. Providing earnings information and other claim-related documentation when required.
• Facilitating appropriate third-party interventions, including Functional Capacity Evaluations (FCEs), Independent Medical Evaluations (IMEs), and other rehabilitation or medical assessments.
• Proactively pursuing claim progression and closure while balancing appropriate care, successful return-to-work outcomes, legislative requirements, and client objectives.

Requirements

• Ontario Paralegal or Lawyer license required.
• Minimum of 5 years of experience in workers’ compensation claims management, including experience managing complex and/or long-duration claims.
• Be a subject matter expertise across Provincial Workers’ Compensation Boards, including applicable workers’ compensation statutes, legislation, policies, procedures, and practices.
• Demonstrate experience with return-to-work planning, rehabilitation strategies, claims resolution, and cost mitigation.
• Have knowledge of workplace health and safety practices and workers’ compensation experience-rating principles.
• Demonstrate analytical and critical-thinking skills, including the ability to evaluate WCB decisions and identify potential appeal, objection, or cost-relief opportunities.
• Have excellent written and verbal communication skills with the ability to communicate effectively with clients, injured workers, WCB representatives, healthcare professionals, and other stakeholders.
• Be able to manage competing priorities and complex cases in a fast-paced, deadline-driven environment. Display great initiative and demonstrated ability to work independently while collaborating effectively across teams.
• Have proficiency with Microsoft Word, Excel, and Outlook.
• Post-secondary education in a related discipline or equivalent experience. Having Human Resources, Health and Safety, Disability Management, Insurance, or another relevant professional experience is preferred.

Benefits

• Comprehensive total rewards package supporting mind, body, wallet, and life.
• Health, dental, and vision coverages starting Day One.
• Wellbeing programs and retirement plans with contribution matching.
• Generous time off and parental leave.
• Continuing education and career growth opportunities.
• Flexible working arrangements to support work-life balance.