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Appeal Case Manager, Quality Assurance and Continuous Improvement-1

  • Toronto, ON, Canada

Full-time

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Job details

Job type
Full-time
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Posting language
English
Posted

Original job description

TELUS Health is empowering every person to live their healthiest life. Guided by our vision, we are leveraging the power of our leading edge technology and focusing on the uniqueness of each individual to create the future of health. As a global-leading health and well-being provider – encompassing physical, mental and financial health – TELUS Health is improving health outcomes for consumers, patients, healthcare professionals, employers and employees.

Our team and what we'll accomplish together

Join our Quality Assurance and Continuous Improvement team, where you'll master a specialized and highly structured appeal process that requires precision, attention to detail, and genuine empathy. You'll be the critical link in ensuring employees receive fair, timely, and accurate support during one of the most important processes in their disability management journey. Working alongside disability management experts, union representatives, and employers, you'll navigate complex, multi-union agreements while maintaining the highest standards of accuracy and privacy. This is not a typical case management role - it's a process-driven, specialized position where your organizational excellence and communication skills directly impact employee outcomes.

What You'll Do


  • Manage a high-volume of active appeal files while maintaining meticulous accuracy and attention to detail in a fast-paced environment
  • Follow defined appeal processes precisely across five distinct union agreements, ensuring compliance with union-specific rules and timelines
  • Engage proactively with employees, employers, and union representatives to gather updated functional information and provide clear communication about appeal status, next steps, and expectations
  • Collaborate with Quality Assurance Advisors and subject matter experts to ensure all case information is accurately documented, properly shared within agreed timelines, and compliant with privacy regulations
  • Review files transferred back from specialists and ensure all information is complete and correct before returning to the employee or employer, preventing delays and escalations
  • Navigate complex, multi-stakeholder situations with professionalism and empathy, building rapport with individuals during challenging circumstances while maintaining strict confidentiality.


What You Bring


  • Ability to follow defined processes precisely and consistently, with strong attention to detail and accuracy in a high-volume environment
  • Excellent written and verbal communication skills, with the ability to explain complex information clearly to diverse audiences (employees, employers, union representatives)
  • Demonstrated ability to handle difficult conversations with empathy, sensitivity, and professionalism while building rapport with individuals during challenging situations
  • Strong organizational and time management skills, with proven ability to manage multiple active files and competing priorities in a fast-paced environment
  • Basic knowledge of medical terminology and ability to review medical information at an entry level
  • Proficiency in Microsoft Office (Word, Excel, Outlook)
  • Customer service mindset with a commitment to accuracy, privacy, and delivering support during sensitive processes.


Great-to-Haves


  • Previous experience in disability case management, benefits administration, or related customer-facing roles
  • Bilingualism (French and English)
  • Familiarity with union processes, collective agreements, or unionized work environments.


A Bit About Us

We’re a people-focused, customer-first, purpose-driven team who works together every day to innovate and do good. We improve lives through our technology solutions and foster a culture of innovation that empowers team members to solve complex problems and create remarkable human outcomes in a digital world.

TELUS is proud to foster an inclusive culture that embraces diversity. We are committed to fair employment practices and all qualified applicants will receive consideration for employment. We offer accommodation for applicants with disabilities, as required, during the recruitment process.

Disclaimer: In accordance with the TELUS Health Solutions Data Center Security Policy, as a condition of employment, all team members whose job functions require they work at a Data Center and/or have access to detailed knowledge of technology related to client service delivery, are subject to a Personnel Security Screening conducted through the Government of Canada.

Note for Quebec candidates: if knowledge of English is required for this position, it is because the team member will be asked, on a regular basis, to interact in English with external or internal parties or to use English applications or software as part of their tasks.

By applying to this role, you understand and agree that your information will be shared with the TELUS Group of Companies’ Talent Acquisition team(s) and/or any leader(s) who will be part of the selection process.
More about this job

Responsibilities

Manage a high volume of appeal files, following the rules and timelines of five union agreements while maintaining accurate documentation and privacy compliance. Communicate appeal updates and gather information from employees, employers, and union representatives, and coordinate with specialists to ensure files are complete and handled empathetically.

Requirements

Candidates should be detail-oriented and able to follow structured processes while managing multiple active files in a fast-paced environment. Strong communication, organization, empathy, basic medical terminology knowledge, and proficiency with Microsoft Word, Excel, and Outlook are required; experience in disability case management or benefits administration and French-English bilingualism are advantageous.

Skills

  • Attention To Detail
  • Accuracy
  • Appeal File Management
  • Process Compliance
  • Written Communication
  • Verbal Communication
  • Empathy
  • Customer Service
  • Organization
  • Time Management
  • Medical Terminology
  • Microsoft Office
  • Privacy Compliance
  • Stakeholder Communication
  • Multitasking

Visa sponsorship

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Categories

  • Healthcare
  • Customer Service & Support
  • Administrative
  • Social Services

Keywords

  • Appeal Case Management
  • Quality Assurance
  • Continuous Improvement
  • Disability Management
  • Appeal Files
  • Union Agreements
  • Collective Agreements
  • Medical Terminology
  • Functional Information
  • Privacy Regulations
  • File Documentation
  • Microsoft Word
  • Microsoft Excel
  • Microsoft Outlook
  • Benefits Administration
  • Customer Service
  • Stakeholder Communication
  • Case Review
  • Confidentiality
  • French-English Bilingualism

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