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Team Leader, Quality Services

Medavie

Ontario, Work From Home

Team Leader, Quality Services

Medavie

Ontario, Work From Home

Job description

Remote
New Brunswick
Nova Scotia
Prince Edward Island
Ontario, Canada
Full time
Posted 4 Days Ago
R-269649

Position Type:

Permanent

If you’re looking for a fulfilling career that can make a real difference in your life, and the lives of others, you’ve come to the right place.

As a national health solutions partner, we put people first in everything we do — and that begins with our team of 8,000+ professionals who bring a cross-section of diverse life experiences and career expertise to Medavie. By collaborating and innovating together, our employees are creating industry-leading solutions in insurance, primary care and emergency medical services that impact millions of lives in Canada each year.

Our mission is to improve the wellbeing of Canadians so that every life can be lived to the fullest — and it’s reflected in our award-winning culture. We celebrate individuality and value the diverse perspectives and skills our employees contribute. We go beyond providing competitive pay and comprehensive benefits to offer opportunities for personal and professional growth, flexible work options, meaningful experiences, and supportive leadership. Medavie is where employees can be their best selves, feel they belong, and achieve their full potential. Be part of it by applying for a position with us today.

Reporting to the Manager, Quality Services, the incumbent leads the Life & Critical Illness (CI) Claims team and the Appeals team, which is responsible for reviewing appeals across all Life and Disability claim lines. The role ensures consistent, fair, and timely adjudication practices, supports complex case decision‑making, and promotes high‑quality service delivery.  


The incumbent provides direction, coaching, and technical expertise to adjudicators and Appeals specialists, ensuring decisions align with contractual provisions, industry standards, and Medavie’s values. This role also contributes to the development and refinement of claims processes, training materials, and documentation to support operational excellence.  


The Team Leader acts as a key liaison between Quality Services, Claims Operations, Medical Services, Legal, and other internal partners. The role supports departmental initiatives, participates in cross‑functional projects, and fosters a culture of continuous improvement and professional development.  



What You’ll Do:


As a Team Leader at Medavie, you will embody our values of Caring, Accountable, Responsive, Innovative and Community-minded while fostering an inclusive, high-performing team environment. Success in this role requires the ability to build organizational knowledge, deliver a strong customer experience, plan and organize effectively, execute against priorities, adapt to change, communicate and collaborate across teams, and coach and develop others to achieve individual and team success.

                                            

Leadership of Life & CI Claims and Appeals Teams 

  • Provide day‑to‑day leadership, coaching, and guidance to Life & CI adjudicators and Appeals specialists. 
  • Support adjudicators with complex, sensitive, or precedent‑setting claims. 
  • Ensure Appeals reviews are completed objectively, consistently, and within service standards. 
  • Oversee workload distribution, case prioritization, and team performance. 

 

Adjudication Quality, Case Review & Decision Support 

  • Provide technical expertise on Life, CI, and Disability contract interpretation. 
  • Review complex or escalated cases, offering recommendations or direction as needed. 
  • Ensure decisions are well‑reasoned, clearly documented, and aligned with policy wording and best practices. 
  • Identify trends in decision‑making and provide coaching to strengthen adjudication quality. 

 

Process Improvement, Documentation & Operational Support 

  • Identify opportunities to enhance claims processes, workflows, and decision‑making tools. 
  • Collaborate with Operations, Medical, Legal, and other partners to refine guidelines and procedures. 
  • Support the development and maintenance of training materials, job aids, and reference documents. 
  • Participate in system or process enhancement initiatives impacting Life, CI, or Appeals workflows. 

 

Reporting, Insights & Stakeholder Communication 

  • Prepare and deliver reports on team performance, Appeals outcomes, trends, and emerging issues. 
  • Communicate updates, risks, and recommendations to leadership. 
  • Maintain strong relationships with internal partners to ensure alignment on claims practices and service expectations.

 

Staff Development & Performance Management 

  • Set individual goals, conduct performance reviews, and develop action plans to support growth. 
  • Provide ongoing coaching, training, and mentorship to build technical expertise and decision‑making confidence. 
  • Foster a collaborative, supportive, and high‑performance team culture. 

 
What You Bring:

  • Post-secondary university or college degree 
  • Minimum 5 years previous experience in Life, CI and/or Disability Claims; Strong understanding of adjudication and Appeals processes  
  • 10 years of experience in the insurance industry (Life and Disability), including 1 year in a supervisory capacity in Life and Disability Case Management.
  • Demonstrated leadership with the ability to coach, support team performance, and drive high engagement effectively.
  • Excellent communication; strong analytical and decision-making skill; ability to manage competing priorities; deep understanding of contract wording and claims practices. 
  • Bilingualism in French and English. English proficiency is required to perform the duties of the role, which include daily collaboration with teams and partners outside Québec who operate primarily in English.

 

What’s in It for You

  • A purpose-driven organization dedicated to improving the well-being of Canadians.
  • A comprehensive benefits plan, including health and dental coverage that is 100% employer paid from day one, plus wellness benefits, health resources, and fitness center discounts.
  • A flexible work environment that supports work–life balance and empowers employees to thrive.
  • Robust professional development opportunities, including leadership programs, ongoing learning, and career growth pathways.
  • A collaborative and inclusive culture where your expertise is valued, your voice matters, and your contributions help shape our product strategy.
  • The opportunity to lead a dedicated team that directly contributes to the quality of service delivered to members and clients.

#CBM1

#LI-VS1


 

This posting is for an existing vacancy within our organization / Ce poste est actuellement vacant au sein de notre organisation.

Pay Range:

88,158 - 99,177 CAD

The Base Pay range may vary depending on the successful candidate or other relevant job-related factors such as knowledge, skills, qualifications, experience and education/training. In addition to Base Pay, eligible Medavie employees may participate in various performance-based incentive programs. Payments under these programs are discretionary and subject to both individual and organizational results.  


We believe our employees should reflect the communities we serve and welcome applications from candidates of all backgrounds. To provide the best experience possible, we will support you with accommodations or adjustments at any stage of the recruitment process. Simply inform our Recruitment team of your needs.  We are committed to making sure recruitment, retention, advancement, and compensation are fair and accessible while following all relevant human rights and privacy laws. We appreciate everyone who has shown interest in this position. Only those selected for an interview will be contacted.


While Medavie may use automated tools, including AI, to support application screening, candidates are expected to complete all recruitment interactions independently—without AI assistance—to ensure a fair and equitable process.


If you experience any technical issues throughout the application process, please email: Medavie.Recruitment@medavie.ca.


We are committed to hiring military and Veteran spouses and encourage you to identify your connection with the MSEN when reaching out to us or applying to any of our open roles.

 

Have questions or want to learn more about us? We would love to hear from you!

joy.bonaidollo@medavie.ca

 

Whenever possible, reach out to a named contact rather than a general inbox  - it helps ensure a quicker, more personalized response. If you hit a bounce-back, let us know at

employment.Emploi@cfmws.com

 

 

About Medavie

 

Who we are

We’re a team of over 8,000 professionals serving clients from coast-to-coast with operations in most provinces. We provide health benefits to nearly 1 in 10 Canadians and manage emergency medical services for nearly 1 in 15 Canadians.

We’ve been a leading health services partner for individuals, employers and governments across Canada for 80 years and a premier all-in-one carrier that provides health, dental, travel, life and disability benefits to individuals and organizations.

We've been recognized as one of Canada's Most Admired Corporate Cultures, one of Canada's Top 100 Employers, and an Imagine Caring Company.

 

What we value

Our values are inherent to our culture and provide the framework for each interaction we have and transaction we make, while providing a clear set of expectations to empower employees to do the right thing for everyone we serve. We are:

Caring – We show compassion in everything we do

Accountable – We follow through on our commitments

Responsive – We have the courage to act and adapt

Innovative – We encourage and value new ideas

Community-minded – We achieve more together

More than simply a poster on the wall, our mission of improving the wellbeing of Canadians represents the purpose of our organization ― and we align that with our culture.

 

What we give back

As a not-for-profit organization, we don’t answer to shareholders. Instead, we invest our earnings in our business, our communities and, most importantly, our employees. We use some of these earnings to support:

Programs to support causes that are close to our employees' hearts, matching the volunteer hours and donations they contribute

An annual United Way workplace campaign led by employees in each of our locations

The Medavie Foundation, which invests in community initiatives and organizations that improve the wellbeing of Canadians, focuses on some of the most pressing mental and physical health challenges facing Canadians.

 

We want to meet you as you are

At Medavie Blue Cross, we foster a culture of openness, understanding and a sense of belonging where everyone can bring their true selves to work. Nearly 70% of our management roles are held by women and we’re committed to creating a diverse, equitable and inclusive workplace where everyone is valued for who they are and what they contribute. We will accommodate people with disabilities during the recruitment, selection and hiring processes.

 

What we offer

If you live our values and deliver results, you’ll experience meaningful, rewarding work in a purpose-centred, inclusive organization that provides:

Flexible work options: We want you to work where you work best. We offer work from home, from the office, or a hybrid of the two, while ensuring you feel connected to your team and to our purpose. Our flexibility goes beyond location. We also have flexible working hours and part-time options available.

Competitive compensation: We believe in rewarding our employees for the skills they bring to their jobs and the results they deliver. This includes competitive compensation that will reflect your experience and expertise and annual performance-based incentives, a 100% employer-matched defined contribution pension plan, an employee RRSP, one-on-one financial counselling, vacation and personal days to help you rest, refuel and balance your life.

Career Growth: Internal talent mobility and growth are an integral part of our success. Employees are empowered to own their career development and have rewarding experiences in a variety of work areas. Supportive leadership will encourage and coach you to maximize your potential so you can access multiple learning pathways to develop. Our leadership development program and other programs, such as mentoring, performance-based management and education assistance, are offered to provide employees with an environment of lifelong learning.

 

Outstanding benefits: Wellbeing is at the centre of everything we do and this starts with our employees. To help you take a proactive approach to your health, we provide:

  • Comprehensive benefits to support you and your family, including fully paid premiums for medical, dental and vision insurance
  • Extensive mental health support (including virtual care options and an employee family assistance program)
  • Health spending and personal wellness accounts that allow you to claim everything from art gallery memberships to Wi-Fi, fitness membership discounts, and more
  • A digital rewards and recognition program to support and empower you on your wellbeing journey
  • Family-friendly and inclusive benefits like maternity and paternity leave top-up, gender affirmation support and fertility coverage to support your growing family

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