Senior Case Manager

You are as unique as your background, experience and point of view. Here, you'll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

OVERALL PURPOSE:

The Client Care Centre Senior Case Manager (SCM) provides consistent, quality client service experience for Group Benefits Clients, Sponsors, and Providers who contact the Client Care Centre. This individual is empathetic and compassionate, with a desire to resolve Client problems. They do this by approaching each case with a client-focused mindset, partnering with internal stakeholders including, but not limited to, the CCC various Tier-2 and Support Team Business Development, Best Practices, Client Advocacy Team, Service Recovery Team, Advisors & Leadership Team, Ombudsman team, Executive Leadership Team, etc. to provide long-term solutions to client issues and concerns while following our Client Problem Resolution Framework. The Senior Case Manager should look at every case as an opportunity to improve our processes and routines, submitting CIs and Knowledge Enhancement requests when necessary.

SPECIFIC ACCOUNTABILITIES:

Escalation Management:

• Resolving our clients problems in a way that meets the highest standard and is aligned with our Client for Life Principles
• Respond to inquiries and Customer Relations Representatives with various demands such as write-off reviews, manager level takeovers, SMEs on complex cases and investigations while ensuring strong feedback coaching, resolve escalated client telephone inquiries from the RCM case pool
• Collaborate with internal stakeholders to resolve Client problems
• Responding to Resolution Case Managers (RCM) inquiries in real time to support First Call Resolution.
• Taking over cases that require further investigation, including escalations from CCRs and RCMs
• Track, action, manage, and resolve all cases that are assigned to you in Suncare
• Follow our Client Problem Resolution Framework
• Maintaining open communication with the Client regarding their case

Operations/ Support Management

• Provide constructive and relevant coaching to CCRs and RCMs, when required
• Recognizing and supporting the elimination of CCR knowledge gaps by providing input to supervisors/managers for coaching purposes.
• Identify opportunities for improvements to business practices and Athena routines and logging said opportunities as CIs or Knowledge Enhancement requests
• Report process inconsistencies and/or identifying trends to support process improvement
• Backing up the telephone queue during high volume periods if required
• Process inquiries and all other inbox items efficiently and effectively with the expected turnaround time for each time of issue
• Log all telephone activity and track escalated inquiries to support the analytic activity
• Make the decision to deny a write off request, or make recommendations to a manager, director or vice president to approve a write-off request
• Consult directly with partners, Client Advocacy, Sun Life executives, Ombudsman and Privacy offices, etc., as required to resolve complaints and escalated issues
• Adherence to the CHCA/RCM processes, analyze claims dispute, and re-evaluate claims as needed

Teamwork, Collaboration, and Engagement

• Commit to working efficiently, cooperatively, and consistently with other team members, colleagues and/or superiors through various projects, learning and development, skills assessment, and/or process improvement
• Ensure compliance with the company's internal and operations policies and guidelines

QUALIFICATIONS AND COMPETENCIES REQUIRED:

• Exceptional client focus, listening skills, and deep understanding of client needs, and empathy and compassion with a strong drive to help our clients and build strong client relationships
• Resourceful / Problem Solver, and ability to identify, plan and solve client problems effectively and efficiently
• Critical Thinking - uses rational and logical decision in acting on situations.
• Demonstrate strong commitment to continuous improvement and quality of work
• Strong time management and organizational skills
• Exceptional communication skills - the ability to speak and write using plain language and Sun Life's caring, optimistic and relevant tone of voice - both with Clients and internal partners, and communicate confidently
• Ability to work independently and take initiative
• Use good judgment - not confined with the basic process. Will go an extra mile if the situations call for it
• Ownership and Accountability - Sets and achieves stretch objectives through a sense of urgency and taking personal ownership
• Positive Attitude towards work - understands and embraces his/her role. A person with high self-motivation
• Responsible - in carrying out tasks assigned to him/her. Understand the impacts of not meeting sensitive deadlines
• Patience - deals with clients and CCRs with professionalism regardless of the inquiry
• GB RCM Skill required

GENERAL CRITERIA FOR INTERNAL JOB APPLICATION:

Qualifiers: All employees with the following qualifications

• Minimum Band Level of 4B
• Performance Rating of 3 or higher during the 2025 Annual Performance Review and in the stack rank for the last 6 months
• Not on corrective action/Performance Improvement Plan and administrative case during or within 3 months prior to the roll out of the IJP
• No reliability issues for the last 6 months

Additional Criteria/ Information

• Must comply with assigned shift schedule or either day or night shift, in line with business requirements
• Must be Work From Home enabled, and with stable internet connection (at least 25mbps)
• Based on business requirements, the organization will reserve the right to make any decisions pertaining to role, tasks of the short-listed candidates, and requirements of the IJP etc.
• Selected candidates to remain part of the team for minimum of 12 months and will not be eligible to apply to another IJP during this period. Scorecards from previous months will be considered to fulfill the minimum requirement for the next progression.
• Recently progressed Band Level are eligible to apply however, their band movement to Band Level respectively will be completed after 12 months of being in their current sub-band and based on the career progression guidelines.
• Employees who do not get selected for the role at the first attempt are eligible to apply after 3 months of initial attempt

Job Category:

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