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Role Description

We have an opportunity in the role of FML Leave Manager responsible for proactively managing Leave of Absence programs and individual FML cases based on plan provisions, state and federal guidelines, and established protocols.

• Interact and consult with key partners including Clients, Claimants, Nurse and Disability Case Managers, Risk Management.
• Administer claims within a variety of group sizes, primarily assigned core and middle market cases, ensuring all regulations and guidelines continue to be met through the duration of the claim.
• Utilize problem solving, analytical, written, and verbal communication skills to deliver timely and appropriate leaves management decisions while providing outstanding customer service to all internal and external customers.
• Maintain case oversight and act as the critical communication link for all parties in FMLA client absence programs including employees, client company, health care providers, and clinical partners.
• Ensure legal compliance, provide timely notifications to employees and client companies, review documentation for approvals and denials, and respond to periodic audits.
• Make recommendations for second and third opinions, independently and when indicated and concurred with by the Manager.
• Maintain FMLA and absence information in Absence Manager Software System, including comprehensive activity notes.
• Provide reports detailing essential information on open and closed absences.
• Manage intermittent occurrences in accordance with approved certifications and identify trends or abuse patterns.
• Identify potentially fraudulent cases.
• Communicate with claimants, plan holders, and physicians as needed for information required for initial and ongoing leave management.

Qualifications

• Minimum of 1+ years' experience working with group disability or absence management, medical disability services or similar preferred; knowledgeable of governing regulations and medical terminology.
• Previous case management, customer service or call center experience desired.
• Bi-Lingual a plus.
• Ability to clearly communicate claim decisions and contract language verbally and in written correspondence.
• FMLA and Group Disability claim experience or group benefit product knowledge strongly preferred.
• Regulatory and Compliance experience a plus.
• Understanding of medical terminology and medical conditions helpful.
• Strong interpersonal and PC skills (e.g., Microsoft Word & Excel).

Requirements

• This is a remote position with no travel required.
• Salary Range: $41,880.00 - $62,820.00
• The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate.

Benefits

• Support and flexibility to achieve your professional and personal goals.
• Opportunities for skill-building, leadership development, and philanthropic activities.
• Contemporary, supportive, flexible, and inclusive benefits and resources.
• Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.