Case Management SME – Complex Injury / TBI Claims Advisory

• Location: Toronto, Ontario
• Remote: Remote
• Type: Contract
• Job #35274

Our client is seeking an experienced Case Management Subject Matter Expert (SME) to support an independent assessment of complex injury and Traumatic Brain Injury (TBI) claims management processes.

The successful consultant will provide expertise across end-to-end claims handling, claimant journeys, rehabilitation coordination, and operational best practices within insurance or regulated environments.

Responsibilities:

• Assess current case management processes, workflows, and claimant journeys
• Review intake, triage, escalation, rehabilitation coordination, and return-to-work pathways
• Support process mapping, operational assessments, and gap analysis
• Evaluate decision points and coordination between internal teams, healthcare providers, and stakeholders
• Provide recommendations aligned with industry best practices
• Participate in stakeholder interviews and contribute to evidence-based reporting

Required Experience:

• 10+ years of experience in case management, claims operations, or related advisory roles
• Strong experience with:
  • Complex / catastrophic injury claims
  • Disability management
  • Rehabilitation coordination
  • Multidisciplinary care models
• Experience within:
  • Auto insurance
  • Disability insurance
  • Workers’ compensation
  • Public sector or regulated insurance environments
• Strong process mapping, assessment, and stakeholder engagement skills

Education / Certifications:

• Degree in Health Sciences, Nursing, Rehabilitation, Insurance, or related discipline
• Certified Case Manager (CCM), CDMP, CRTWC considered an asset
• CIP / FCIP designation considered an asset

Experience with no-fault or care-first auto insurance models is highly preferred.