Job Summary
To provide medical insight and assessment to members’ health to assist the claims assessors in reaching outcome decisions for Group Protection health policy claims (namely group income protection policies). For Income Protection policies, to determine and develop vocational rehabilitation plans that successfully deliver Early Intervention and Rehabilitation Services to employees and employers, ensuring safe return to work at the earliest opportunity. Work with employers to educate them on the benefits of early intervention support for employees, including how to proactively manage health concerns and reduce the risk of submitting invalid claims.
What You’ll Do
* Provide clinical guidance and support to the claims assessors regarding the assessment and management of claims.
* Hold discussions and conduct interviews with members and employers to ascertain the detailed biopsychosocial factors pertaining to the employee’s health.
* Document comprehensive objective reports to communicate accurate medical/vocational opinion to enable accurate claim decisions against policy terms and conditions.
* For Income Protection Policies, establish and monitor rehabilitation programmes to achieve successful return to work activity, including liaising with relevant external medical professionals. This could be prior to a claim being submitted (early intervention support) or while a claim is in payment.
* Provide specialist vocational guidance and support including recommendations on reasonable adjustments to both employers and claims assessors to achieve a successful absence resolution within the terms of the group Income Protection policy.
* Ensure liability is limited to the time required for the claimant to safely return to work.
* Train, mentor and develop internal and external customers on the benefits of early intervention and rehabilitation.
* Acquire and apply a detailed knowledge of Group Claims/underwriting Strategy/Philosophy and of Group products.
Who You Are
* Knowledge of principles, methods and procedures for diagnosis, treatment and rehabilitation of physical and mental conditions to provide accurate and appropriate information in relation to all claim/underwriting management activity, including rehabilitation initiatives.
* Demonstrate and apply a detailed knowledge of relevant legislation including the Equality Act 2010, Health & Safety at Work Act 1974 and all available National Institute for Health & Care Excellence Guidelines.
* Strong communication skills – active listening with an ability to identify verbal/non-verbose cues and act appropriately while displaying a non-judgemental attitude; clearly express ideas and opinions both verbally and written.
* Influencing abilities – express views and ideas to relevant parties to promote access to relevant support services, overcome return to work barriers and manage absence appropriately.
* Interpersonal skills – conduct detailed medical/vocational interviews with claimants and liaise with employers to manage current absence and facilitate successful return to work when appropriate.
* Customer service orientation – develop constructive and cooperative relationships with employees and employers to understand current absence and identify appropriate return to work pathways.
* Analytical skills – evaluate biopsychosocial information to provide detailed analysis and documentation of current health and future return to work capability, supporting assessors in decisions against policy terms and conditions.
* Problem-solving – identify and present viable solutions to overcome return to work barriers.
* Decision making – develop detailed return to work plans to support and achieve successful outcomes.
* Organise, plan and prioritise work to achieve successful service delivery.
Qualifications
* A qualified health care professional, registered and/or accredited with the relevant professional body (desirable).
* Relevant background and recent experience in vocational rehabilitation within the insurance industry (desirable).
Benefits Of Working At Canada Life
We offer a competitive salary and comprehensive reward package, including a generous pension and bonus scheme, income protection, private medical insurance and life assurance. Additional benefits and supports are available, as well as regular personal and professional development opportunities.
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