[Hiring] Integrated ADM Specialist @LifeWorks

Role Description

The Integrated ADM Specialist serves as the primary subject matter expert and facilitator for the Americans with Disabilities Act (ADA) interactive process as well as the Pregnancy Workers Fairness Act (PWFA). Responsibilities include overseeing, managing, processing, and adjudicating FMLA, State, and company-specific leaves, as well as straightforward and complex STD claims.

• Analyze reported Family Medical Leave (FMLA) requests and make determinations based on Federal and State regulations.
• Communicate clearly with clients and claimants on all aspects of the claims process.
• Ensure that claim management processes are followed per best practices and client-specific steps.
• Guide employees and clients through the reasonable accommodation process, mitigating legal risk.
• Ensure a seamless integration between short-term disability (STD), FMLA/leaves, and ADA requirements.
• 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 to explain the leave management process.
• Develop and document an understanding of the situation and factors supporting or inhibiting a successful return to work.
• Review all relevant information and consult with appropriate medical resources as required.
• Analyze FMLA medical certifications and ensure claim determination adheres to regulatory compliance timeframes.
• Inform STD claimants of any documentation needed to process a claim and manage claim status.
• Determine an appropriate return-to-work goal with the employee and employer.
• Act as the primary case contact and communicate proactively with the employer’s representatives.
• Follow all processes as laid out in operating procedures and trainings/meetings.
• Attend Case Management and Disability Management department team meetings and trainings as required.
• Other projects and tasks as assigned.

Qualifications

• Minimum 5+ years of direct experience managing Leaves, STD, and ADA/PWFA claims or high-level disability case management.
• Computer skills and the ability to work primarily online in a paperless environment.
• Strong interpersonal and helping skills along with assessment and problem-solving skills.
• Deep understanding of the Americans with Disabilities Act (ADA), Pregnancy Workers Fairness Act (PWFA), FMLA, and state-specific leave laws.
• Experience in managing self-insured Short Term Disability (STD) Plans as well as company-specific paid and unpaid leave policies.
• Ability to review and interpret medical documentation and translate clinical restrictions against essential job functions.
• Exceptional conflict resolution and negotiation skills, with the ability to handle sensitive medical information with confidentiality and empathy.

Requirements

• Key collaborative relationships with US Disability Case Managers, Medical Providers, Client contacts, and Service Delivery Managers.

Working Conditions

• Environment: Primarily a professional remote environment.
• Physical Demand: Sedentary. High volume of telephonic and computer-based work.
• Mental Demand: Requires a high degree of emotional intelligence and the ability to manage stressful situations involving employee health and legal compliance.

Benefits

• Inclusive culture that embraces diversity.
• Accommodation for applicants with disabilities during the recruitment process.