Case Manager - HYBRID (Personne gestionnaire de cas - Hybride)

Job Summary:Responsible for entitlement decisions and managing claims through developing, implementing, communicating, and monitoring comprehensive case management plans for all activities.Case Managers proactively make and communicate benefit and service decisions in a timely manner, ensuring consistency with WSIB policy. They address worker and employer needs by actively listening, gathering information, and clarifying rights, responsibilities, and obligations.They may handle cases at various stages of the case lifecycle, including pre-1990 claims, following a structured framework to achieve high-quality entitlement decisions, return-to-work, recovery outcomes, and effective case planning.Major Duties and Responsibilities:Make entitlement decisions:

Based on legislation, policy, and best practices; communicate decisions verbally and in writing; gather information from workplace parties and healthcare providers; educate parties on benefits, policies, and their rights; ensure accurate earnings information; monitor compliance; determine breaches and adjust benefits accordingly.Develop and monitor case management plans:

Collect information, assess recovery paths, set goals, and make decisions; plan activities collaboratively; participate in case conferences; coordinate and review activities; close cases when appropriate; evaluate case effectiveness.Facilitate return-to-work (RTW):

Identify RTW factors, remove obstacles, and promote safe return to suitable work; coordinate RTW efforts; support workplace parties; arrange assessments and plans; share best practices; keep clients and employers informed.Coordinate interventions:

Refer requests for healthcare, equipment, and modifications; liaise with relevant resources; ensure timely completion of interventions.Handle disputes and requests:

Attempt to prevent or resolve disputes; process reconsiderations and appeals.Conduct reviews:

Use knowledge of case management and policies to perform quality reviews.Perform other duties as required.Job Requirements:Education:

University degree at undergraduate level.Experience:

Minimum of two years in adjudication or case management and customer service. Adjudication involves decision-making based on guidelines, policies, and laws; case management involves assessment, planning, facilitation, and advocacy to meet individual needs.Note:

Position is eligible for education equivalency. Additional experience may substitute for education on a 2:1 basis, with a minimum threshold of a college diploma over one year and up to two years plus six years of experience.Additional Information:

No equivalencies for professional certifications or designations.Our commitment to equity, diversity, and inclusion:

We value diversity and aim to create an inclusive environment. We follow accessible employment practices under AODA. Accommodations are available upon request during ..... full job details .....