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Leave Case Manager

The Company:  CAIC PFML
The Location: 

Windsor, CT, US, 06095

The Division:  PLADS
Job Id:  3192

*Candidates must reside in Connecticut*         

 *Multiple positions, this is a hybrid role and candidates are required to be in the office 2 days per week                                                                                                                                                                                                                                         

Job Summary

 

Under general supervision of the team manager, this position is responsible for administering various clients’ Family Medical Leave Act (FMLA) policy and performing various clerical duties to support the administration and operational functions of the unit.

 

Principal Duties & Responsibilities

 

• Assists associates with leave of absence requests and guides them through the process

 

• Processes all leave of absence paperwork according to established procedures and laws

 

• Provides timely and accurate responses to associates and all levels of management concerning day-today issues and activities

 

• Administers the FMLA policy; reviews FMLA documentation for accuracy and completeness

 

• Makes recommendations to approve or deny requests for FMLA based on federal regulations 

 

• Reviews reconsideration requests on denied claims and take approproate action to uphold or overturn claim decision

 

• Analyzes and monitos claim transactions to ensure accuracy and prevent possible fraudulent activities 

 

• Coordinates correspondence, forms, and other documents via the claim system

 

• Generates reports as required; maintains files, inputs and analyzes data

 

• Assists management with leave of absence situations and provides guidance within the policy and established legal guidelines

 

• Keeps complete records of all LOA requests and maintains tracking and analysis of data

 

• Participates in developing goals, objectives, and systems.

 

• Maintains compliance with standards and federal/state regulations

 

• Serves as an internal reference to the team for certification requirements and processing

 

• Contacts Providers for clarification

 

• Supports management with special projects as necessary

 

• Performs other duties as assigned

 

Education & Experience Required

 

  • Minimum Required Bachelor's Degree In a related field
  • Minimum Required 1 - 2 years of related experience

 

Or an equivalent combination of education and experience

 

Job Knowledge & Skills

 

• Current knowledge of the integrated disability and absence management industry

 

• Excellent customer service skills and ability to manage difficult and stressful situations

 

• Strong communication skills – written, verbal, persuasion, motivation, facilitation of strong working relationships

 

• Ability to manage business expectations and resolve concerns, by communicating status and issues

 

• Ability to effectively prioritize and escalate customer issues

 

• Ability to interpret and analyze multiple facts

 

• Knowledge of state and federal FMLA regulations

 

• Knowledge of medical disability management preferred

 

• Strong organizational skills

 

• Excellent interpersonal skills

 

• Ability to work in a team environment

 

 • Ability to meet or exceed Performance Competencies

 

Competencies

 

  • Acting with Integrity 
  • Communicating Effectively 
  • Pursuing Self-Development 
  • Serving Customers 
  • Supporting Change 
  • Supporting Organizational Goals 
  • Working with Diverse Populations 

 

 


Nearest Major Market: Hartford