Claims Risk Manager Jobs in Toronto, ON (NOW HIRING)

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Job Description:

The Director, Underwriting and Claims Risk Management for Sun Life Canada is recognized in the Canadian Insurance claims community as a high performing claims and underwriting leader who thrives on the challenge of applying innovative problem-solving skills to improve the claims experience. Through active, hands-on leadership they will foster a collaborative, results oriented environment for claims adjudicators across the Claims Centre of Excellence (COE). The Director will provide claims expertise with internal and external parties including Product, Underwriting, Legal, Reinsurers and Investigators. This role will also be involved in overseeing cross functional underwriting tasks for new business applications.

What you will be doing:

• Support the VP, Chief Underwriter and Claims Risk Officer.

• Promote excellence and consistency in claims risk assessment across SLF Canada.

• Develop and conduct claim reviews/audits for Individual and Group products within the Claims COE and recommend periodic changes to the review programs as well as the claims career ladders and progression model.

• Continuously contribute to the development of the organization's claims philosophies by monitoring emerging trends and best practices. Recommend and implement changes to claims philosophies, practices and processes and assists with new technologies.

• Champion and advocate for a positive and consistent claims experience for all clients of SLF Canada

• Participate in and coordinate reinsurance audits and ongoing communications regarding changes to claims policies

• Keep abreast of emerging trends and industry practices

• Act as a senior claims resource for complex and high dollar cases, providing deep technical expertise, consulting with Legal, Medical and Chief Claims Officer as necessary to resolve escalations

• Partner and build relationship with industry reinsurance partners and engage in discussions related to complex claims

• Manage and oversee rescissions and fraud risks related to new business applications.

What you need to succeed:

• Industry related courses ACS or ALHC.

• University degree, with preference given to medical, science, legal or business

• Minimum 10 years of claims adjudication experience including deep knowledge of Life, Critical Illness, Disability and Long-Term Care

• Minimum of 5 years in a leadership role.

• Problem Solvingand Analytical skills- ability to analyze and resolve complex issues.

• Strong People Skills - ability to handle escalated cases, build relationships, influence outcomes and negotiate difficult situations

• As this position is posted in several locations, we specify that bilingualism (French, English, both oral and written) is required for Quebec only for the frequent interactions with English and French-speaking colleagues or internal partners across Canada or worldwide.

What's in it for you?

• Being a member of the Sun Life family, a group of people united by our Purpose: to help Clients and Employees achieve lifetime financial security and live healthier lives.

• As a hybrid organization, you and your leader use business and Client needs to choose where you work, at home or in the office.

• We're committed to creating an inclusive and respectful environment. Our goal is to make sure all our employees have the chance to live up to their full potential.

• We are thrilled to be recognized by Excellence Canada with their top-level certification, the Canada Order of Excellence for Mental Health at Work, for prioritizing employee well-being, fostering a positive work culture, and achieving excellence in mental health.

The Base Pay range is for the primary location for which the job is posted. It may vary depending on the work location of the successful candidate or other factors. In addition to Base Pay, eligible Sun Life employees participate in various incentive plans, payment under which is discretionary and subject to individual and company performance. Certain sales focused roles have sales incentive plans based on individual or group sales results.

Diversity and inclusion have always been at the core of our values at Sun Life. A diverse workforce with wide perspectives and creative ideas benefits our Clients, the communities where we operate and all of us as colleagues. We welcome applications from qualified individuals from all backgrounds.

Persons with disabilities who need accommodation in the application process, or those needing job postings in an alternative format, may e-mail a request to thebrightside@sunlife.com.

We are proud to be a hybrid organization that offers our employees the choice and flexibility to work from both the office and virtually based on the needs of the business, our Clients and you! Several work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

We may use artificial intelligence to support candidate sourcing, screening, interview scheduling.

We thank all applicants for showing an interest in this position. Only those selected for an interview will be contacted.

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