Guardian is looking for a FML Leave Manager to proactively manage our Leave of Absence programs and individual FML cases. In this role, you’ll ensure all activities are based on plan provisions, state and federal guidelines, and established protocols while delivering outstanding customer service experiences.
What You'll Do
- Interact and consult with key partners including Clients, Claimants, Nurse and Disability Case Managers, and Risk Management.
- Administer claims within a variety of group sizes, primarily assigned core and middle market cases, ensuring all regulations and guidelines are met through the duration of the claim.
- Utilize problem solving, analytical, written, and verbal communication skills to deliver timely and appropriate leaves management decisions.
- Maintain case oversight and act as the critical communication link for all parties in FMLA client absence programs including employees, client companies, health care providers and clinical partners.
- Ensure legal compliance, provide timely notifications, review documentation for approvals and denials, and respond to periodic audits.
- Make recommendations for second and third opinions, independently and when indicated.
- Maintain FMLA and absence information in the 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.
What We're Looking For
- Minimum of 1+ years' experience working with group disability or absence management, medical disability services, or a similar field.
- FMLA and Group Disability claim experience or group benefit product knowledge.
Nice to Have
- Previous case management, customer service, or call center experience.
- Bi-Lingual ability.
- Regulatory and Compliance experience.
- Understanding of medical terminology and medical conditions.
Technical Stack
- Microsoft Word
- Microsoft Excel
- Absence Manager Software System
Benefits & Compensation
- Compensation: $41,880.00 - $62,820.00
- Support and flexibility to achieve your professional and personal goals.
- Opportunities for skill-building, leadership development, and community building.
Work Mode
This is a fully remote position.
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
