Health is the result of over a decade of dedicated visionary leaders and innovative organizations challenging the status quo for PAC management solutions. We do healthcare differently and we are changing healthcare one patient at a time. How might you ask? By hiring talented clinicians, engineers, analysts, and healthcare leaders to create and utilize cutting edge technology to provide the patient with the best level of care for the right amount of time.
Why Is This Role Critical?
The Leave Administrator is accountable for coordinating and processing claims activities for Maternity, Short-Term Disability (STD), FMLA, Medical, and Personal Leave of Absence claims per internal policy and legal requirements. The Leave Administrator reviews and coordinates claims; effectively communicates with claimant, management, and treatment providers, and processes payroll consistent with applicable policies to ensure all leave claims are timely processed correctly.
What you will be accountable for.
Administers and coordinates integrated claims management involving Short Term Disability (STD), Long Term Disability (LTD), Family Medical Leave Act (FMLA), Medical and Personal Leaves in accordance with the respective organization's Plan Documents, policies 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.
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.
Collaborates, educates, advises, and maintains positive relationships between client groups, management, employees and human resources by serving as a liaison to procure specialty services (leave administration) such as notification of employees' rights and reviewing requests for leaves while ensuring equitable treatment of employees. Identifies new or existing management employees who need information/consultation regarding leaves and provides information accordingly.
Facilitates effective communication between management and employees regarding leaves of absence to promote employee morale and maintain an environment conducive to controlling costs and increasing productivity consistent with applicable leave laws and company policies.
Calculate and code hours owed into the payroll system for employees on leave. Answer employee questions and concerns regarding disability pay and/ salary continuation.
Manages restricted work program within the organization for disabled workers, in partnership with vendors and company policy. Oversees colleagues that are placed in temporary placements in or outside of their regularly assigned department to ensure restrictions and schedules are adhered to by the colleague member and management.
Maintains up to date knowledge of the laws and pertinent legal parameters pertaining to the administration of leaves, working closely with internal partners.
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.
What you will need to be successful
Bachelor's Degree in Business Administration, Human Resources, Health management or related field OR equivalent experience preferred
Minimum of three (3) years of experience administering leave management (STD/LTD/FMLA) with general welfare benefit experience
Knowledge of benefits administration, including, but not limited to, IRS Code Section 125 regulations, COBRA, FMLA, ADA, HIPAA, IRS, FLSA regulations
Proficient in MS Office (Word, Excel, Outlook)
Strong interpersonal skills including ability to communicate effectively, build relationships, and anticipate needs
Ability to recognize confidential information and maintain it in the strictest of confidence
Strong math skills with the ability to conduct complex analysis of claims, budget projections, etc.
Strong reasoning ability in order to research complex questions / situations and formulate appropriate resolutions and recommended process changes.
The nice to haves
Health is a pioneer in post-acute care and care transitions with a combined unprecedented 19 years of experience that uniquely positions us to manage patients, improve clinical and financial outcomes, and share risk with payors and providers. We provide clinical support alongside scalable technology and advisory solutions that empower health systems, health plans, and post-acute providers to navigate care episodes across the continuum, with the goal of reducing waste and improving patient outcomes.
We care about the people we serve.
We care about each other.
We care about our communities.
We embrace innovation.
We like simple.
Health is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.