Job Summary
Job Description
What is the opportunity?
As a Clinical Specialist, you will analyze medical information on disability claims in a team-oriented, multi-disciplinary digital environment. You will also proactively partner with claim adjudicators, doctors and rehabilitation specialists to provide input, set clinical direction and implement clinical strategies across multiple product lines for Life & Health Claims to deliver effective service solutions to enhance outcomes. You will participate in projects and initiatives.
What will you do?
• Responsible for critical analysis of medical information on Life & Health claims to determine extent and impact of medical/psychiatric condition, medical restrictions and limitations and expected duration of medical condition.
• Deliver cost efficient work product and for effective utilization of resources in order to maintain cost and appropriate risk management activities.
• Provide input, set clinical direction and implement clinical strategies across multiple product lines for Life & Health Claims.
• Serving as a lead subject matter expert and is responsible for training, coaching and mentoring on clinical claim management strategies, processes and procedures.
• Take ownership of client problems through first call resolution coaching and escalate as appropriate.
What will you need to succeed?
Must have:
• RN or BSCN designation in nursing required
• 5 years' experience of current, proven clinical experience, in occupational health, rehabilitation or case management, industrial disability management, worker's compensation, psychiatric, cardiac, emergency care or orthopedic nursing
• Strong analytical and decision-making skills as well as excellent oral and written communication skills
• Demonstrated ability to effectively deal with customers in a manner that is professional with a high degree of customer service
• Demonstrated ability to thrive in a high-pressure environment with times constraints.
• Proficiency in MS Office application, PowerPoint, and/or similar applications
Nice to have:
• Demonstrate a growth mindset and ability to adapt to challenges, learning from experiences and continuously improving performance
• Bilingual in French and English, both written and spoken
What's in it for you?
• A Total Rewards program that includes flexible benefits, work/life balance and career development programs and investment and retirement savings plans
• Competitive pay and high-earning potential
• All the tools, training, and team support you need to grow your career
• Flexible work/life balance options
• Sophisticated RBCI software tools to boost your productivity
Job Skills
Customer Service, Decision Making, Effectiveness Measurement, Insurance Operations, Insurance Product Development, Operational Delivery, People Management, Process Management, Strategic Thinking, Time ManagementAdditional Job Details
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Inclusion and Equal Opportunity Employment
At RBC, we embrace diversity and inclusion for innovation and growth. We are committed to building inclusive teams and an equitable workplace for our employees to bring their true selves to work. We are taking actions to tackle issues of inequity and systemic bias to support our diverse talent, clients and communities.
We also strive to provide an accessible candidate experience for our prospective employees with different abilities. Please let us know if you need any accommodations during the recruitment process.
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