Case Manager (Part Time)

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 workplace 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.

The Case Manager will oversee, manage, process, and adjudicate FMLA, State, municipal and company specific leaves as well as straightforward 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). 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.

• Manage and process FMLA (and other Federal leaves as applicable), Military, State leaves; company specific leave claims as well as straightforward STD claims. With regards to leaves, will manage all DOL categories with the exception of: Adult child, reduced hours and high usage estimates for intermittent leave.
• Conduct case assessments, contact 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 (e.g. health professionals, supervisory team, external vendors) to confirm decision (approved / denied) recommendation on FMLA, State, Company specific leaves and STD cases.
• Analyzes medical certifications and other medical documentation and claim determination adheres to the required regulatory compliance timeframes.
• 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.
• Attend Case Management and Disability Management department team meetings and trainings as required.
• Will follow all processes as laid out in the Standard Operating Procedures (SOPs), and/or as detailed in trainings/meetings.
• Other projects and tasks as assigned.

• The ideal candidate has 2 years comprehensive experience in US Leave and Disability Case Management and knowledge of the various legislative requirements.
• Strong interpersonal and helping skills along with assessment and problem-solving skills.
• Excellent computer skills and the ability to work primarily online in a paperless environment.

• You have a registered professional status within the disability management or professional health sector.
• Having 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 (Spanish speaking).Associate’s Degree.