The Workplace Safety and Insurance Board (WSIB) helps people overcome workplace injuries and illnesses and helps business owners make their workplaces safe and healthy. Our people are at the heart of what we do. Bring your enthusiasm and expertise to the WSIB, and we'll help you achieve your personal and professional goals through meaningful work, development opportunities and a culture of compassion, integrity and teamwork.
We are the WSIB. And we're here to help.
What can I expect to do in this role?
Contribute to organizational and service excellence of Health Services, the Health Care Strategy and the Compliance Strategy by designing, implementing, monitoring and evaluating a quality management program that will ensure quality of services with emphasis on clinical quality provided by contracted health care providers (e.g., through Regional Evaluation Centres, Specialty Clinics) and non-contracted health care providers (e.g. through Community Mental Health Program and other health care programs and initiatives) and overall performance against established standards and/or service level agreements. Establish targets for providers and programs and ensure that they are being achieved.
Conduct comprehensive audits at the program and provider level as well as individual cases to ensure health care interventions are appropriate; identify any performance gaps and recommend solutions. Provide advice, direction and consultation to WSIB staff and management regarding the appropriateness of health care and return to work recommendations and advice about health care professionals delivering services within their scope of practice outlined within their respective Colleges
How do I qualify?
Key Accountabilities and Responsibilities:
1. Using quality management strategies/principles, design, implement, monitor and evaluate the services of health care providers through a quality management program to ensure that programs (e.g. Regional Evaluation Centres, Specialty Clinics, Community Mental Health Program, other health care programs) and providers are outcome focused, timely and cost effective and directed to return to work through an effective quality management program. This will include analyzing clinical outcomes data submitted by the health care providers using various outcome measurement tools, such as DASH©, Beck Depression Inventory, SF-36 or Sheehan Disability Scale, and reporting results.
2. Manage day-to-day issues raised by Case Management and/or Complex Claims staff and management, health care providers and others. This includes conducting the clinical review process to ensure workers referred to programs receive sound, clear, best evidence- based recommendations and treatment interventions that achieve WSIB standards and timely resolution of issues.
3. Monitor, evaluate and oversee provider and program performance to ensure quality and service standards are being maintained. This includes:
• Reporting on provider performance relative to service level agreement (SLA), worker satisfaction and program objectives to ensure WSIB is obtaining the maximum value from contracts and/or standards;
• Identifying quality improvement opportunities and developing recommendations/options as appropriate;
• Assessing and determining acceptable action plans to address any identified deficiencies in service levels;
• Communication with providers to discuss their performance, current scorecard and action plan for remediation;
• Monitoring results of implemented action plan and recommending to management corrective action which could include possible penalties and suspension of contract;
• In collaboration with the WSIB management, prepare and present findings on identified trends, outcomes and recommendations to WSIB senior management as well as to senior management of programs under review.
4. Use databases to capture data and monitor progress for the quality management programs and other initiatives. Conduct reviews of data obtained from various data tools (e.g. performance measurement tool, monthly statistical reporting tool, Cognos, etc.) to identify trends and anomalies in billing, timeliness of referrals, accessibility, utilization, etc. Develop reports including recommendations for presentation to management using qualitative and quantitative measures.
5. As a technical resource, provide reports on clinical programs, services and providers, which include analysis, findings of clinical reviews, compliance with service level agreements (SLAs) and/or adherence with contract standards as well as recommendations addressing gaps in program delivery. Provide presentation of key performance indicators to management for discussion with providers, recommending audits and program development opportunities; and recommend and implement performance management plans to assist providers in meeting service level standards or service expectations.
6. Audit individual cases for appropriateness and outcomes of the provided health care to workers and provide feedback to management with recommendations for program improvements, such as process changes and additional provider training.
7. Develop training material on programs or services and deliver content as required as subject matter expert. Participate in training providers on WSIB programs, services and processes based on findings from the quality management program.
8. Assist management in the contract initiation and renewal process by preparing Requests for Proposals (RFPs) or Requests for Information to solicit services for renewal of contracts or new provider contracts. Collaborate with Legal Services and Finance to negotiate and produce new contracts including incorporating fee schedules, performance measurement standards. Collaborate with Finance and Purchasing to review and evaluate RFP responses to select providers; provide advice in the determination and recommendations on contract renewals to ensure workers' and WSIB needs are being met.
9. Lead and/or participate in project teams involving health care strategy. Collaborate with others within the Health Services Division and throughout the organization to ensure work is aligned and integrated.
10. Perform other related duties as assigned or required.
Professional Requirements and Qualifications
• University completion at the post graduate level with a Masters in Psychology
• Four years prior experience in a clinical environment with quality management experience related to psychology
• Demonstrated strong communication skills (verbal and written) as well as strong interpersonal skills.
• Demonstrated ability to manage and prioritize workload providing high quality customer service.
• Demonstrated analytical, problem solving and critical thinking skills.
• Demonstrated ability to work both independently and as part of a team.
• Demonstrated strong leadership and judgment skills
How to Apply
As a precondition of employment, the WSIB will require a prospective candidate to undergo a criminal records name check prior to or at any time following hire.
To apply for this position, please submit your application via
The WSIB Job Opportunities site by the closing date.
We appreciate the interest of all candidates. Due to the volumes of applications we receive, we are only able to contact candidates that are selected to move forward in the recruitment process. The WSIB is an equal opportunity employer.
The WSIB is an equal opportunity employer and provides accommodation for job applicants in accordance with the Human Rights Code and the Accessibility for Ontarians with Disabilities Act. If you are an individual with a disability and you need accommodation in order to apply for this position, please contact talentacquisitioncentre@wsib.on.ca. If you are invited to participate in the assessment process, please provide your accommodation needs at that time. Please be advised that you may be required to provide medical documentation to the WSIB's Corporate Health Department so that appropriate accommodation can be provided to you throughout the recruitment process.
