Disability Case Manager

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.

• The Disability 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 outlined process flows and client specific processes. 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.

Responsibilities :

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 resources as required (e.g. health professionals, supervisory team, ) 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.

Qualifications :

• 2-4 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 would be an asset.
• 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) would be an asset.
• Associate’s Degree would be an asset.

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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.