Job Details

Under limited direction, the Leave Management Specialist is accountable for reviewing and coordinating all types of claims for employees relating to leaves of absence; effectively communicating with employees, management, and treatment providers; and collaborating with Fiscal Services and management ensuring payroll is consistent with applicable Metro Health policies to ensure all leave claims are timely processed correctly. The Leave Management Specialist also is responsible for coordinating all aspects of any requested workplace accommodations, including but not limited to working through the interactive process with employees requesting workplace accommodations and working with organizational leaders to implement effective workplace accommodations, as well as documenting all aspects of that interactive process and providing education to leaders with respect to Metro Health’s leave management and reasonable accommodation processes.

Requirements:

• Bachelor’s Degree in Business Administration, Human Resources, Health management or closely related field.
• Three (3) years of experience administering leave management (STD/LTD/FMLA/Disability Management/Workers’ Compensation) with general welfare benefit experience strongly preferred.
• Knowledge of general health benefits administration, including, but not limited to, Medical, Prescription, Dental, Vision and Voluntary Disability benefits.
• Experience utilizing claims management software strongly preferred.
• Knowledge of benefits administration, including, but not limited to, IRS Code Section 125 regulations, COBRA, FMLA, ADAAA, HIPAA, IRS, FLSA regulations.
• Proficient in MS Office (Word, Excel, Outlook)
• Certification as a Professional in Human Resources preferred.
• Strong verbal and written communication skills with all levels within and outside the organization.
• Strong reasoning ability in order to research complex questions / situations and formulate appropriate resolutions and recommended process changes.
• Strong attention to detail, specific ability to track/manage leave designations and time sensitive requests.

Essential Functions and Responsibilities:

1. Works collaboratively across the organization to identify, develop and implement key initiatives, programs and specific tools relating to leave and workplace accommodation management, while supporting the organization and assessing potential organizational needs relating to leave of absence and workplace accommodation management.
2. Manages and coordinates integrated claims management involving Short Term Disability (STD), Long Term Disability (LTD), Parental Leave, Family Medical Leave Act (FMLA), Salary Continuation, Medical and Personal Leaves in accordance with the organization’s Plan Documents, policies, procedures and applicable laws that govern them. Coordinates integrated claims management with STD and LTD vendors to provide timely and accurate customer service. Investigates and follows up on abnormal and/or inconsistent activities with a claim.
3. Serves as a liaison between treatment providers, ergonomic consultants, vendors, staff, management, and other HR staff to protect the rights of claimants/employees and reduce potential organizational exposure. Communicates with providers of medical treatment regarding qualifying reasons and anticipated length of leave/disability period, and/or employee medical restrictions.
4. Coordinates interactive discussion with employees, leaders and/or applicable HR and EHS staff regarding medical restrictions and potential reasonable accommodation(s), including analysis of any potential undue hardships, direct threats and other potential outcomes. Monitors duration of leaves, and restricted work, and partners with manager to coordinate return to work,  alternative work arrangements, leaves of absence and/or separation of employment in the rare instance where effective reasonable accommodation cannot be achieved.
5. Collaborates, educates, advises, and maintains positive relationships between client groups, management, employees, Employee Health Services and Human Resources by serving as a liaison to procure specialty services (leave administration) such as distributing mandated notification(s) to employees and timely reviewing requests for leaves, medical restrictions and workplace accommodations while ensuring equitable treatment of employees. Identifies new or existing management employees who are in need of information/consultation regarding leaves and medical restrictions, and provides information accordingly.
6. Facilitates effective communication between management and employees regarding leaves of absence and workplace accommodations to promote employee morale and maintain an inclusive work environment, remaining mindful of the need to control costs and increasing quality and productivity consistent with applicable leave laws and Metro Health’s policies and procedures.
7. Responds to employee and management questions and concerns regarding leave, medical restrictions, disability pay and/ salary continuation in a timely manner. Communicates with payroll, management and employee to ensure disability pay is correctly allocated. Provides appropriate documentation into the IDM Claims management computer data base and the hardcopy files consistent with department standards.
8. Assists with the restricted work program across the organization, in collaboration with Employee Health. Oversees staff placed in temporary placements in or outside of their regularly assigned department to ensure restrictions and schedules are adhered to by the staff member and management.
9. Maintains up to date knowledge of the laws and pertinent legal parameters pertaining to the administration of leaves, working closely with HR Business Partners, Legal Services, Compliance and external partners.
10. Collaborates with and supports the Senior Benefit Specialist, serving as back up benefit administrator as needed.
11. Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning and continuing education opportunities, and participating on committees, task forces, and work groups as determined by management.