Were looking for a Care Manager to join our Insurance Operations team at this role you are expected to use your clinical expertise to assess clinical information on low to moderate exposure claims following established business protocols. You will validate and interpret clinical evidence against policy or plan provisions to determine benefit eligibility for Long-Term Care (LTC) claims.
Position Responsibilities:
Assess clinical needs to determine initial eligibility for long term care benefits
Ongoing monitoring of claims for high-risk activity
Make benefit eligibility determinations based on onsite/virtual assessments functional/cognitive screening forms and/or other clinical evidence on ongoing claims
Appropriately set clinical follow updates based on current protocols
Complete trainings as assigned to maintain currency with protocol and guideline updates
Collaborate with other business units as needed to provide optimum service to customers
Participate in regular one-on-one meetings with management attend staff meetings and attend other work activities as directed by manager
Collaborate with senior care management staff on specific claim questions to ensure accurate decision-making
Required Qualifications:
Bachelors degree in Nursing with an active and valid PHRN or USRN license
Excellent communication and interpersonal skills with sound clinical judgment and decisionmaking abilities
Proficient in Microsoft Office applications and quick to learn new systems and technologies
Preferred Qualifications:
At least 5 years of clinical nursing experience ideally in geriatrics long-term care and/or chronic illness management
Experience in the Long-Term Care industry highly desirable; geriatric nursing background preferred
When you join our team:
Well empower you to learn and grow the career you want.
Well recognize and support you in a flexible environment where well-being and inclusion are more than just words.
As part of our global team well support you in shaping the future you want to see.
About Manulife and John Hancock
Manulife Financial Corporation is a leading international financial services provider helping people make their decisions easier and lives better. To learn more about us visit is an Equal Opportunity Employer
At Manulife/John Hancock we embrace our diversity. We strive to attract develop and retain a workforce that is as diverse as the customers we serve and to foster an inclusive work environment that embraces the strength of cultures and individuals. We are committed to fair recruitment retention advancement and compensation and we administer all of our practices and programs without discrimination on the basis of race ancestry place of origin colour ethnic origin citizenship religion or religious beliefs creed sex (including pregnancy and pregnancy-related conditions) sexual orientation genetic characteristics veteran status gender identity gender expression age marital status family status disability or any other ground protected by applicable law.
It is our priority to remove barriers to provide equal access to employment. A Human Resources representative will work with applicants who request a reasonable accommodation during the application process. All information shared during the accommodation request process will be stored and used in a manner that is consistent with applicable laws and Manulife/John Hancock policies. To request a reasonable accommodation in the application process contact .
Working Arrangement
Required Experience:
Manager
Manulife is a leading financial services group. We provide financial advice, insurance, as well as wealth and asset management solutions for individuals, groups and institutions.