Case Manager Disability

TELUS; Houston (TX); Remote; USD 41,000 - 76,000; Full time

Benefits offered by this job

Flexible benefits plan

3 weeks vacation

Remote work options

Job summary

TELUS Santé recherche un(e) gestionnaire de cas congés et STD pour superviser les demandes FMLA, congés d'État et les cas STD, en évaluant l’éligibilité et en assurant un soutien continu tout au long du processus.

Vous travaillerez principalement à distance, avec collaboration avec les équipes internes et les clients externes, en respectant les exigences réglementaires et les politiques internes.

Qualifications

• Minimum 3+ years of direct experience managing Leaves and STD disability case management.
• Connaissance approfondie FMLA et des leaves étatiques.
• Capacité à interpréter des documents médicaux et à proposer des accommodations.
• Excellentes compétences interpersonnelles et de communication.
• Grande confidentialité et empathy dans le traitement des informations médicales.

Responsibilities

• Gérer les congés FMLA et les autres congés fédéraux, militaires et étatiques; cas STD.
• Réaliser des évaluations de cas et contacter les employés et leurs interlocuteurs.
• Établir les éléments favorables et les obstacles à un retour au travail.
• Examiner les informations pertinentes et consulter les ressources appropriées.
• Déterminer un objectif RTW et soutenir le processus de retour au travail.
• Servir de contact principal et communiquer avec les représentants du client tout au long du cas.

Skills

Leaves management

STD management

FMLA knowledge

Communication

Education

Associate’s Degree

Job description

À TELUS Santé, nous donnons à chacun les moyens de vivre plus sainement. Guidés par notre vision, nous exploitons la puissance de notre technologie de pointe et misons sur l’unicité des personnes pour créer le futur de la santé. En tant que chef de file mondial des services de santé et de bien-être – englobant la santé physique, mentale et financière – TELUS Santé améliore les résultats en matière de santé pour les consommateurs, les patients, les professionnels de la santé, les employeurs et les employés.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 – encompassing physical, mental and financial health – TELUS Health is improving health outcomes for consumers, patients, healthcare professionals, employers and employees.Our team and what we’ll accomplish togetherEmployees 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 Concurrent Disability Case Manager will oversee, manage, process, and adjudicate Short-Term Disability (STD) claims and leave requests (FMLA, State, and company-specific). This position is responsible for evaluating eligibility based on federal, state, and plan-specific regulations, communicating clearly with clients and claimants throughout the claims lifecycle, and ensuring ongoing case management adheres to company best practices and client-specific workflows.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.What you’ll doManage and process FMLA (and other Federal leaves as applicable), Military, State leaves; company specific leave claims as well as STD claims.Conduct case assessments, contact the employee and their client contacts, by telephone, email or adhoc meetings, 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 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 as well as applicable STD policies undefined Informs STD claimants of any documentation needed to process a claim, timeframe requirements, claim 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 client contact and intervene when necessary.Act as the primary case contact and will communicate proactively and continuously with the employer’s representative(s) regarding any case management matters that may be required through the life of claim. Will follow all processes as laid out in the operating procedures and/or as detailed in trainings/meetings.Attend Case Management and Disability Management department team meetings and training as required.Other projects and tasks as assignedWhat you bringMinimum 3+ years of direct experience managing Leaves and STD 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.Regulatory Expertise: Deep understanding FMLA, state specific leave lawsCompany policies and plans: Experience in managing self-insured Short Term Disability (STD) Plans as well as company specific paid and unpaid leave policies.Medical Literacy: Ability to review and interpret medical documentation andtranslate clinical restrictions against essential job functions and make recommendations related to workplace accommodations.Communication: Exceptional conflict resolution and negotiation skills, with the ability to handle sensitive medical information with extreme confidentiality and empathy.Key Collaborative Relationships withUS Disability Case Managers: peer to peer support and review of claims and client processes.Medical Providers: Regular interaction with nurses and physicians to validate documentation provided to appropriately review the case against policies and STD plans.Client contacts: Collaborating with client-side leadership on a continual basis via telephone, email and meetings, as needed.Service Delivery Managers: Maintaining constant communication to ensure client satisfaction and operational efficiency.Working ConditionsEnvironment: Primarily a professional remote environment.Physical Demand: Sedentary. High volume of telephonic and computer-based workMental Demand: Requires a high degree of emotional intelligence and the ability to manage stressful situations involving employee health and legal compliance.Great-to-havesRegistered 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.Salary Range: $58,100-$107,900 CADActual total compensation will be determined based on factors such as knowledge, skills, performance and experience. We encourage all qualified candidates to apply, even if the posted salary range doesn't match your expectations. We're open to discussing competitive compensation packages tailored to your experience level and expertise.TELUS offers rewarding benefits, which may vary per job function, such as:Comprehensive total rewards package highlighting competitive salary and bonus structures, minimum 3 weeks of vacation, and flexible benefits plan to meet the needs of you and your familyFlexibility to work in-office, virtually or a combination of bothGenerous company matched pensionOpportunity to give back to communities in which we work, live and serveCareer growth and learning & development opportunities to develop your skillsAnd much more…Job Type: This is for a current vacancy.À propos de nousNous sommes une équipe axée sur les personnes, les clients et les objectifs, qui collabore, innove et crée des retombées positives au quotidien. Nous améliorons des vies grâce à nos solutions technologiques. Nous favorisons une culture d’innovation qui permet aux membres de l’équipe de résoudre des problèmes complexes et de produire des résultats exceptionnels sur le plan humain dans un monde numérique.À TELUS, nous sommes fiers de notre culture qui encourage la diversité. Nous croyons foncièrement à l’importance d’adopter des pratiques équitables en matière d’emploi. Ainsi, le dossier de tous les candidats qualifiés est étudié. Pendant tout le processus de recrutement, nous tenons compte des besoins particuliers des candidats handicapés, au besoin.Avertissement : Conformément à la Politique de sécurité des centres de données de TELUS Santé, tout membre de l’équipe susceptible de travailler dans un centre de données ou d’avoir accès à des renseignements détaillés sur les technologies de service client peut faire l’objet d’une enquête de sécurité auprès du gouvernement du Canada.Remarque aux candidats du Québec : si la connaissance de l’anglais est requise, c’est parce que le/la membre d'équipe qui occupera ce poste sera appelé(e), sur une base régulière, à interagir en anglais avec des parties externes ou internes ou encore à travailler dans un environnement informatique anglais dans le cadre de ses tâches.En déposant votre candidature pour ce rôle, vous comprenez et acceptez que vos informations seront partagées avec l'(les) équipe(s) d'acquisition de talents du groupe de sociétés TELUS et/ou tout gestionnaire impliqué dans le processus de sélection.