Disability Case Manager

TELUS Health and LifeWorks have recently come together to leverage the power of technology and our caring cultures to further progress our shared goal of building a healthier and friendlier future for all. As a global-leading health and well-being provider – encompassing physical, mental and financial health – TELUS Health is improving health outcomes for consumers, patients, healthcare professionals, employers and employees. Absence and Disability Management Our Absence and Disability Management business helps employers achieve improved health and productivity outcomes with services focused on absence reporting, proactive case management and effective return-to-work support for a variety of employee health risks or conditions, whether related to physical, mental, social or workplace health. Through our leave administration services, TELUS Health provides clients with improved leave compliance to federal, state and municipal regulations as well as company-specific policies. Employees can be absent from work for a variety of reasons: casual absence, work-related illness and/or injury, or health issues requiring the employee to be away from the work place for an extended period.  Our absence management program helps employers strategically manage those absences- focusing on reducing overall costs, realizing administrative efficiency, and enhancing support for employees and employers.  All with the goal of returning employees to health and productivity.    Summary The Disability 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. To analyze reported Family Medical Leave (FMLA) requests; to make determinations based on Federal and State regulations; to communicate clearly with clients and claimants on all aspects of the claims process; and to ensure that on-going claim management is within Standard Operating Procedures (SOPs) and Service Level Agreements (SLAs).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. 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 Succeeding as a Disability Case Manager requires the following core qualifications and skills 2 years of comprehensive experience in US Leaves and Disability Case Management and knowledge the various legislative requirements Developed 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 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 Management of ADA / ADAAA claims, would be an asset Bilingual (English and Spanish) would be an asset #LI-JD1 #LI-remote #LifeAtTELUS #HiringNow TELUS Health is an Equal Opportunity Employer. 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. Where permitted by law, company employees must be fully immunized to access a TELUS Health office or customer premises. Persons with disabilities who need accommodation in the application process or those needing job postings in an alternative format may e-mail a request to talentacquisitiononboarding@telushealth.com. By applying to this role, you understand and agree that your information will be shared with the TELUS Group of Companies’ Talent Acquisition team(s) and/or any leader(s) who will be part of the selection process. Being part of the team at TELUS Health is more than a job; it’s a career-defining experience. It allows you to do innovative and meaningful work with talented and collaborative teams. It’s an opportunity to improve businesses and lives by building healthier, happier workplaces. And it’s a chance to build genuine, long-term relationships along the way. A place to experience more Find the support and encouragement to consistently push boundaries and deliver impactful solutions. Our collaborative culture means your ideas will be heard and your hard work will be rewarded. You will be leveraging our world-leading technology, products, clinical services and passionate team members to revolutionize access to health care and wellbeing, and drive remarkable experiences for the benefit of all the clients and individuals we serve around the world. Talented people who care Coming to work each day is an opportunity. It’s a chance for you to work with a multidisciplinary global team of nearly 10,000 smart and driven members whose passion for their work matches your own, resulting in helping create a healthier future for everyone. Work that matters Make a difference in the lives of our clients and their employees every day – by providing meaningful solutions in more than 160 countries, that help people and businesses perform at their best by delivering both digital innovation and clinical services to improve total physical, mental and financial health and wellbeing across the full spectrum of primary and preventative care.