The WSIB currently has 1 permanent NEL Clinical Specialist vacany and two temporary NEL Clinical Specialist vacancies for up to 12 months in duration. Please visit our WSIB careers page to apply.
To render and administer Non-Economic Loss (NEL) decisions related to permanent impairment in accordance with the Workplace Safety and Insurance Act as well as WSIB operational policies.
Major Duties & Responsibilities
1. Conduct clinical reviews for all NEL decisions including determinations, redeterminations, and reconsiderations on appeals by:
· Determining the most appropriate method of rating the permanent impairment percentage/quantum;
· Determining the percentage /quantum of permanent impairment based on the medical information on file and/or NEL medical assessments and ensuring the decision is in compliance with the AMA Guides, legislation, policies, and NEL practice and processes;
· Performing complex calculation functions, authorizing benefit payment and evaluating and approving payment for medical assessment reports prepared by the roster physicians.
2. Communicate information regarding the NEL decision and processes to all parties by:
· Providing written explanations for all decisions (including appeals).
· Informing and educating all parties regarding NEL decisions, permanent impairment diagnoses, entitlement, NEL processes, policies, legislation, practices, and guidelines;
· Participating in case conferences and informal collaboration to ensure consistency in the interpretation and application of the AMA Guides.
3. Provide high level technical advice to internal parties (senior managers, managers, case managers, physicians, appeals resolution officers, WSIAT, the Legal Branch, the Policy Branch) with respect to NEL ratings, decisions, processes, policies, practices, and guidelines both informally and formally.
4. Maintain knowledge and up to date information on all matters related to NEL processes and practice by:
· Participating in research activities to ensure NEL practice standards and decision-making are consistent with evidence-based literature;
· Providing recommendations to NEL management regarding the need for revision of practices, procedures and guidelines, the handling of new or complex NEL issues and the implementation of policy and practice changes;
· Developing, implementing, and evaluating the NEL Clinical Specialist education program as needed and providing peer mentoring as required.
5. Participate in quality assurance related activities within the NEL department by:
· Attending regularly scheduled clinical practice meetings;
· Participating in committee work to improve the consistency of approach regarding NEL decisions and processes.
6. Perform other related duties as required or assigned.
- University completion at undergraduate level with a specialty focus in Nursing. Member of the College of Nurses of Ontario required.
- Membership in good standing with the College of Nurses of Ontario
- 4 years minimum experience, 3 years' experience in clinical environment and 1 year experience on the job to reach full working level