Disability Case Manager managing FMLA and other Federal leaves at TELUS Health. Overseeing claims processing and ensuring compliance with regulations in a supportive role.
Responsibilities
Manage and process FMLA (and other Federal leaves as applicable) Military leaves, State leaves, company specific and STD claims.
With regard to FMLA, will manage all DOL category claims; including re-certifications and the 2nd and 3rd opinion processes
Conduct case assessments, contacting the employee and their manager / HR by telephone or email, to explain the leave management process, employee accountabilities, and gather information for assessment purposes
Develop and document an understanding of the situation and the factors supporting, as well as inhibiting, a successful return to work for the employee
Review all relevant information and consult with appropriate MSI resources as required (nurse consultants, health professionals, supervisory team) to confirm decision (approved / denied) recommendation on FMLA, State, Company specific leaves and STD cases
Analyzes FMLA medical certifications and other medical documentation and ensures claim determination adheres to the required regulatory compliance timeframes
Informs STD claimants of any documentation needed to process a claim, timeframe requirements, claim’s status (e.g. STD approvals, denials, and consults), or any other information necessary to manage a claim
Determine an appropriate RTW goal with the employee and the employer; as well as, provide active support for the return-to work planning process between the employee and their supervisor and intervene when necessary
Communicate proactively with the employer’s HR representative regarding any case management issues that may impact the workplace and RTW planning
Will follow all processes as laid out in the Standard Operating Procedures (SOPs), and/or as detailed in trainings/meetings
Attend Case Management and Disability Management department team meetings and trainings as required
Other projects and tasks as assigned
Requirements
2+ years of comprehensive experience in US Leaves and Disability Case Management and knowledge the various legislative requirements
Strong interpersonal and helping skills along with superior assessment and problem solving skills
Excellent computer skills and the ability to work primarily online in a paperless environment
Associate’s Degree: you have a registered professional status within the disability management or professional health sector
Additional course work in occupational health, rehabilitation, legislation related to disability management, helping relationship skills, mediation, human resource management, disability insurance, psychological and workplace factors in disability would be an asset
Bilingual (English and Spanish) considered an asset
Management of ADA / ADAAA claims, considered an asset
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