Director Case Management (Medical) - ref. l6041603

Job Description:

Director Case Management (Medical)

This role will work closely with the VP of Case Management and Director, Case Management, to collaborate, develop and communicate a vision aligned with the company’s strategic direction.

• Manage budget-related operating and salary expenses.
• Ensure production standards are met with a focus on quality and quantity of care.
• Clarify and enforce policy and underwriter intent for the team.
• Evaluate key performance metrics and business plan trends.
• Communicate corporate vision, business strategy, and results to all employees.
• Review and resolve third-level disputes or complaints from clients and providers, escalating when necessary.
• Lead, resolve, and escalate non-routine or complex cases as needed.
• Ensure departmental processes and guidelines focus on optimizing the client experience and reducing claim costs.
• Develop and implement policies, procedures, quality standards, and monitoring systems to track results, issues, and compliance.
• Establish and maintain workflow procedures and standards for case management principles and guidelines.
• Assist in the implementation of new business systems.
• Collaborate with other departments and leaders to enhance cross-site coordination and ensure understanding of case management workflows.
• Ensure the continuous delivery of services 24/7, 365 days a year.
• Foster and maintain employee engagement to support a highly productive environment.
• Ensure staff understand how their roles impact customer satisfaction and business objectives.
• Cultivate a positive, results-driven work environment.
• Provide the team with necessary tools and resources for efficiency and effectiveness.
• Implement performance management practices for all team members, including direct reports, by actively monitoring activities, measuring performance, and providing feedback on business objectives. Address areas of concern and recognize strengths.
• Continuously pursue industry education and development opportunities to stay current on effective medical case management strategies.
• Success Measures
• Achievement of measurable quality and efficiency targets.
• Budget FTE by role vs. cases managed.
• Corporate client complaints vs. cases managed.
• Corporate client audit results.
• Meeting service standards.
• Staff retention rate.

• Bachelor's degree required.
• Nursing degree and license preferred.
• Understanding of North American and international medical systems, travel insurance, insurance terminology, and case management.
• Medical experience in a fast-paced hospital environment is preferred.
• Awareness of trends, treatments, and legislative changes impacting case management services
• Contact center and management experience.
• Strong leadership and coaching abilities in a team environment.
• Strong prioritization and decision-making skills.
• Understanding of project management processes.
• Ability to handle, communicate, and exchange sensitive and confidential information professionally.
• Excellent organizational and time management skills.
• Strategic thinking and vision development capabilities.
• Ability to interpret data trends.
• Ability to manage and measure work effectively.
• Talent selection and team-building expertise.
• Experience managing large teams.
• Ability to leverage innovation.
• Excellent verbal and written communication skills.
• Adaptability to ongoing change in a fast-paced, customer-focused setting.
• Active participation in relevant travel insurance industry events.
• Flexible schedule required.
• Some travel required.

When you apply:

If you require assistance or accommodation during our recruitment process, please notify Human Resources so that we can review and consider how we may be able to assist you based on your individual needs.

We offer you:

• We offer a competitive compensation package that includes a base salary, performance bonus and an extensive benefit package;
• A professional future with opportunities for development, growth, and advancement;
• RRSP Match program;
• Work/life balance, health and wellness initiatives including an excellent EAP program;
• Employee engagement programs that focus on fitness, food, and fun.

To get a taste of the Global Excel life and for more information on our company, visit our Facebook page and website: