Volk - Case Manager - Edmonton, Alberta, Canada

Kelly Volk

Edmonton, Alberta, Canada

Services

Case Manager

Summary:

Excellent communication skills and has the ability to adapt to a continual changing environment.
Can handle calls of sensitive or emotionally charged nature.
Well organized with excellent problem solving ability and can work with minimum supervision.
Due to the complexity of the work, I am detailed oriented due to the many contract stipulations I have worked on.
Yet, I am quite flexible and can adapt to many situations very quickly.
I am accumstomed to working under pressure and with tight deadlines.
I am a strong team player, with a high interest in working in a cross-functional team envirnonment and can make decisions quickly.

Work History

Abilities Specialist

Sobeys

Handling Leaves of Absences (LOAs) (STD/LTD/Maternity/Personal Leaves) throughout Western Canada. I am constantly communicating with various departments on each employee's claim status; I am consistently dealing sensitive issues and handling materials that require close attention to detail, continuously working within tight time frames; working under pressure, along with working alongside human resources personnel when facilitating return to work processes.
• Leave of absence management process (STD/LTD/Maternity/Personal Leave) (3000 employees)
• Communication with case management protocols and various collective agreements internal staff members
• Developed modified and gradual return to work programs for employees who are able to return to work.
• Ensuring that duty to accommodate process is followed as per legislation guidelines.
• Applying trouble-shooting methods when challenging situations arise for departments with high absenteeism.
• Extensive process review and documentation• Special projects as assigned

Disability Benefit Specialist

Clean Harbors

November 2011 - October 2012

Dealt with each form of Leave of Absences (LOAs) (STD/LTD/Maternity/Personal Leaves/Death Claims) throughout Canada. These LOAs involve communicating with all team members (internal / external providers), paying close attention to detail, and working within tight time frames, working under pressure, collecting benefit premiums while absent from the work place and facilitating return to work processes.
• Leave of absence management process (STD/LTD/Maternity/Personal Leave/Death claims) (5000 employees)
• STD/LTD presentations along with the communication with case management protocols and various collective agreements with brokers and external vendors
• Developed modified and gradual return to work programs for employees who are able to return to work.
• Ensuring that duty to accommodate process is followed as per legislation guidelines.
• Applying trouble-shooting methods when challenging situations arise for departments with high absenteeism.
• Assisted departments when dealing with WCB rules and regulations as each ruling is applied to each province.
• Extensive process review and documentation
• Collected premiums from employees on leaves of absence
• BC Health enrollments along with trouble-shooting on accounts
• Special projects as assignedCareer History 'd)

Benefit Analyst (Maternity Fill - Contract Position)

Stantec

January 2011 - October 2011

Responsible for a case load of absences throughout Canada ranging from Short-term to long-term. These absences range from personal leaves with and without compensation to compassionate, maternity, vacation and long-term illness.
• Leave of absence management (STD/LTD, Maternity, WCB, Personal Leaves) (3000 employees)
• Problem solving with internal team members as well as brokers and vendors on group benefits and retirement plan inquiries/problems
• Process review and documentation• New hire and other benefit presentations
• Special projects as assigned

Claims Facilitator

Alberta School Employee Benefit Plan

March 2007 - August 2010

Responsible for a case load of individuals (union based) that ranged from pre and post surgical claims to psychological claims and those that required on-going support during extreme medical treatments.
• Adjudicated medical information to determine entitlement of disability benefits (both STD & LTD) and ensured covered members received all benefits and services to which they were entitled.
• Managed STD through to recovery, expiry or through to the transition of LTD following claim requirements and protocols.
• Created and facilitated the development and communication with all parties involving the return-to-work plans, including union representatives either at the employer's worksite, in person at their home or through conference calls.
• Prepared documentation, letters, reports, and case notes, along with responding to inquires from covered members, their employers, the designated healthcare providers and union representatives.
• Actively involved all parties in the planning and development of policies, procedures and programs to ensure they were designed in a manner that facilitated all parties in the best fashion.
• Worked alongside WCB when workers were injured on the job and then progressed to STD and to CPP disability if needed.
• Assisted employers in managing absenteeism from a proactive approach.

Illness and Injury Coordinator

PCL/Horizon/CNRL

First contact point for 3000 individuals that worked on a 24 hour construction plant. Handled & reported all WCB claims in the appropriate time frame as well as kept abreast of any new changes in all Collective agreements with the various work forces.
• Adjudicated claims according to procedures and standards; coordinated return-to-work (per each collective agreement) for various workers on the job site, as per their specific illness/injury on a continual basis.
• Continuous employee / employer communication on claim status (both verbal and written).
• Managed workers' concerns, ensuring their needs were addressed by appropriate medical personnel on and off site
• Troubleshooting to facilitate a better versatility between the employee/employer.
• Excellent interpersonal and team-building skills through interaction with a broad range of stakeholders, such as patients, physicians, nurses, clinical staff and management
• Coordinated with external stakeholders, including insurance providers, union representatives of various unions' external physicians and clinical specialists.
Career History 'd)

Program Assistant

Grey Nuns Hospital - Emergency Department

Reported directly to the Manager of the Emergency Department. Troubleshooted various patient concerns; enrolled staff members in a variety of courses for staff development; as well as did payroll for the Emergency department.

• Completed practicum with Caritas Health Group, including staff claims (union based) at the Grey Nuns, Edmonton General and Misericordia hospitals
• Assisted in minimizing barriers in return-to-work claims (medical and non-medical claims).
• Coached various parties on the minimizing of barriers for a more streamlined return-to-work
• Managed patient concerns, ensuring their needs were addressed by appropriate medical personnel
• Worked alongside various unions when facilitating return-to-work plans.
• Streamlined business processes to ensure better staff utilization for resource management
• Excellent interpersonal and team-building skills through interaction with a broad range of internal and external stakeholders (i.e. patients, physicians, nurses, clinical staff, management, insurance providers and clergy)

Supervisory/Administrative Term Positions

Royal Alexandra Hospital and Aberhart Centre

• Supervised a staff of 3
• Generated various reports/letters for internal and external customers
• Made travel arrangements and prepared expense reports for a department of 125 staff members
• Maintained company-specific libraries
• Transcribed and prepared documentation for senior executive
• Assisted with the scheduling of events surrounding video-conferencing

Administrative/Medical Aid Personnel

Workers' Compensation Board Alberta

Supported five various departments in an administrative support role. Managed calendars, booked appointments; and assisted clients with interpretation of procedures and policy interpretation.

• Provided case management assistance, with patient healthcare and therapy
• Completed financial documentation of accounts pertaining to patient wellbeing
• Responsible for program management, including scheduling of specialists, physicians and therapists to ensure patients' return-to-work on a timely basis

Projects

Case Manager

Currently working on obtaining my Bachelors of Health Administration Degree

Return-To-Work-Coordinator

Excellent communication skills and has the ability to adapt to a continual changing environment. Can handle calls of sensitive or emotionally charged nature. Well organized with excellent problem solving ability and can work with minimum supervision. Due to the complexity of the work, I am a stickler for details due to the many contract stipulations I have worked on. Yet, I am quite flexible and can adapt to many situations very quickly. I am accumstomed to working under pressure and with tight deadlines. I am a strong team player, with a high interest in working in a cross-functional team envirnonment and can make decisions quickly.

Return-To-Work Coordinator

Excellent communication skills and has the ability to adapt to a continual changing environment. Can handle calls of sensitive or emotionally charged nature. Well organized with excellent problem solving ability and can work with minimum supervision. Due to the complexity of the work, I am a stickler for details due to the many contract stipulations I have worked on. Yet, I am quite flexible and can adapt to many situations very quickly. I am accumstomed to working under pressure and with tight deadlines. I am a strong team player, with a high interest in working in a cross-functional team envirnonment and can make decisions quickly.

Work with each individual to return them back to work within a designated time frame which promotes an efficient and effective manner for both the employer and employee.
Have worked on all types of leaves of absences (Maternity, Paternity, Compassion, Death, WCB, STD and LTD) Canada wide.
Communicate with the employee, employer, all healthcare providers, union representatives, lawyers, OHS and human resource personnel in verbal and written correspondence.
Conducted telephone interviews focusing on gaining relevant information not evident in already provided documentation.
Identified and assessed non-medical influencing factors pre and post disability, functional capability and medical information in order to understand drivers of recovery in order to positively impact a recoveryand a solution.
Created and negotiated return to work plans with claimants and employers.
Assisted employers to reduce areas with high absenteeism.

Case Manager

Assessed both STD and LTD claims for ongoing entitlement by reviewing contractual, medical, functional and occupational information.
Managed STD claims through to recovery, completion or through to the transition of LTD.
Developed and maintained outcome focused case management directed towards ethically influencing early and timely recovery, where appropriate.
Work with each individual to return them back to work within a designated time frame which promotes an efficient and effective manner for both the employer and employee.
Have worked on all types of leaves of absences (Maternity, Paternity, Compassion, Death, WCB, STD and LTD) Canada wide.
Communicate with the employee, employer, all healthcare providers, union representatives, lawyers, OHS and human resource personnel in verbal and written correspondence.
Conducted telephone interviews focusing on gaining relevant information not evident in already provided documentation.
Identified and assessed non-medical influencing factors pre and post disability, functional capability and medical information in order to understand drivers of recovery in order to positively impact a recoveryand a solution.
Created and negotiated return to work plans with claimants and employers.
Assisted employers to reduce areas with high absenteeism.

Qualifications & Certifications

Health Administration Degree

Athabasca University

Grant MacEwan University, Metro Community College, Grant MacEwan University

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