Concurrent Disability Case Manager

TELUS Health•Chicago, IL

11d

About The Position

TELUS Health’s absence management program helps employers manage employee absences, reduce costs, improve administrative efficiency, and support employees and employers in returning employees to health and productivity. The Concurrent Disability Case Manager oversees, manages, processes, and adjudicates Short-Term Disability (STD) claims and leave requests, including FMLA, state, military, federal, and company-specific leaves. The role evaluates eligibility under applicable federal, state, and plan-specific requirements, communicates with clients and claimants throughout the claims lifecycle, and manages cases according to company best practices and client-specific workflows. The case manager assesses barriers to a timely and successful return to work, coordinates with stakeholders to address those barriers, and supports a return-to-work plan or appropriate alternative. The role requires interpreting medical documentation, making recommendations in accordance with applicable policies and regulations, and maintaining confidential, proactive communication with employees, employers, medical providers, and internal partners.

Requirements

At least 3 years of direct experience managing leaves and STD disability case management.
Computer skills and ability to work primarily online in a paperless environment.
Strong interpersonal and helping skills, as well as assessment and problem-solving skills.
Deep understanding of FMLA and state-specific leave laws.
Experience managing self-insured Short-Term Disability plans and company-specific paid and unpaid leave policies.
Ability to review and interpret medical documentation, translate clinical restrictions against essential job functions, and make workplace-accommodation recommendations.
Exceptional conflict-resolution and negotiation skills.
Ability to handle sensitive medical information with extreme confidentiality and empathy.

Responsibilities

Manage and process FMLA and other applicable federal leaves, military leave, state leave, company-specific leave claims, and STD claims.
Conduct case assessments and contact employees and client contacts by telephone, email, or ad hoc meetings to explain the leave-management process and employee responsibilities and gather assessment information.
Develop and document an understanding of the circumstances and factors supporting or inhibiting a successful return to work.
Review relevant information and consult appropriate resources, such as health professionals, supervisors, and external vendors, to confirm recommendations on leave and STD case decisions.
Analyze medical certifications and other medical documentation, ensuring claim determinations comply with regulatory timeframes and applicable STD policies.
Inform STD claimants about required documentation, deadlines, claim status—including approvals, denials, and consultations—and other information needed to manage claims.
Determine an appropriate return-to-work goal with the employee and employer, support return-to-work planning, and intervene when needed.
Serve as the primary case contact and communicate proactively and continuously with employer representatives throughout the claim.
Follow operating procedures and processes described in training and meetings.
Attend Case Management and Disability Management department meetings and training as required.
Complete other projects and tasks as assigned.