Case Manager Disability

LifeWorks; United States; Remote; USD 41,000 - 76,000; Full time

Benefits offered by this job

Flexible benefits plan

Minimum 3 weeks vacation

Remote work options

Generous pension match

Job summary

TELUS Health is seeking a Concurrent Disability Case Manager to oversee STD, FMLA and state leaves in a primarily remote environment in Canada. You will assess eligibility, communicate with employees and client contacts, and coordinate with health professionals to ensure compliant, timely decisions.

You will support return-to-work planning, maintain strong client relations, and adhere to STD policies while handling sensitive medical information with confidentiality and empathy.

Qualifications

• Minimum 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 laws
• Company 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 and translate 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 collaborations with US Disability Case Managers, Medical Providers, Client contacts, Service Delivery Managers.

Responsibilities

• Manage and process FMLA and other Federal leaves; Military, State leaves; company-specific leave claims as well as STD claims.
• Contact employees and client contacts by phone/email/meetings to explain the leave management process and gather information.
• Develop and document understanding of the situation and factors supporting return to work.
• Review all information and consult with health professionals, supervisors, and vendors to confirm decisions on leaves and STD.
• Analyze medical certifications and ensure compliance timeframes and STD policy adherence.
• Inform claimants of documentation, timeframes, status, and other information needed.
• Determine appropriate RTW goal with the employee and the employer; support RTW planning.
• Act as primary case contact and communicate with employer representatives throughout the claim.
• Follow processes in operating procedures and trainings.
• Attend Case Management and Disability Management meetings and trainings.
• Other projects and tasks as assigned.

Skills

Regulatory expertise

Company policies

Medical literacy

Communication skills

Bilingual Spanish

Education

Associate’s Degree

Job 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 - encompassing physical, mental and financial health, TELUS Health is improving health outcomes for consumers, patients, healthcare professionals, employers and employees.

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 together

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 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 do

• Manage 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 assigned

What you bring

• Minimum 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 laws
• Company 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 and
• translate 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
  • US 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 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.

Great-to-haves

• 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.

Salary Range: $58,100-$107,900 CAD

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 family
• Flexibility to work in-office, virtually or a combination of both
• Generous company matched pension
• Opportunity to give back to communities in which we work, live and serve
• Career growth and learning & development opportunities to develop your skills
• And much more…

Job Type : This is for a current vacancy.

A bit about us

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.

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.

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.