[Hiring] Disability Case Manager @LifeWorks

Role Description

TELUS Health is empowering every person to live their healthiest life. Guided by our vision, we are leveraging the power of our leading edge technology and focusing on the uniqueness of each individual to create the future of health. As a global-leading health and well-being provider, TELUS Health is improving health outcomes for consumers, patients, healthcare professionals, employers, and employees.

The Case Manager will oversee, manage, process, and adjudicate FMLA, State, municipal and company specific leaves, as well as straightforward and complex STD claims; to determine benefits due pursuant to an STD plan: and to ensure the ongoing processing of claims. The case manager assesses any barriers to a successful and timely return-to-work and engages with stakeholders to implement strategies to address those identified barriers and support return to work or an appropriate alternative plan.

Responsibilities

• Manage and process FMLA (and other Federal leaves as applicable), Military leaves, State leaves, company specific and STD claims.
• 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).
• Analyze FMLA medical certifications and other medical documentation and ensure claim determination adheres to the required regulatory compliance timeframes.
• Inform 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; 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.
• 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.

Qualifications

• 2+ years of comprehensive experience in US Leaves and Disability Case Management and knowledge of 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 coursework 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.
• Western USA home based preferred.

Benefits

• We’re a people-focused, customer-first, purpose-driven team who works together every day to innovate and do good.
• We improve lives through our technology solutions and foster a culture of innovation that empowers team members to solve complex problems and create remarkable human outcomes in a digital world.

Company Description

TELUS Health is an Equal Opportunity Employer that aims to foster an inclusive culture that embraces diversity. It is our policy to hire without regard to race, color, creed, religion, national origin, citizenship status, sex, marital status, age, disability, sexual orientation or veteran status. We offer accommodation for applicants with disabilities, as required, during the recruitment process.