Leave Program Specialist At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive to
bend the cost curve in healthcare for all. Our dedication to service excellence extends to all our stakeholders - internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential.
Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward
JOB SUMMARY This position is responsible for leave of absence administration and case management. Provide exemplary customer service to employees, management and HR business partners. The incumbent serves as the subject matter expert for leave of absence programs who works independently, relying on experience and judgment to administer leave cases. Assignments are varied in nature requiring independent thinking and ingenuity. The incumbent performs a variety of tasks with some being complex and will escalate most complex issues to a higher level. Works under the general direction and leadership of Benefits and legal department.
DUTIES - Interpret and administer leave of absence and paid sick time programs/policies in accordance with applicable federal and state laws (FMLA, ADA, USERRA, Pregnancy Discrimination Act, workers' comp., etc.). Ensure compliance with regulations when processing leave claims. Stay current with latest legislative changes and be able to identify overlapping laws to determine those that applicable each leave case.
- Manage all aspects of leave claims; independently approve/deny requests based on relevant medical information. Investigate and review information submitted for claim/case to ensure compliance with policies. Ensure HIPAA and privacy guidelines are effectively executed.
- Establish and maintain all communications with employees on leave and coordinate return to work process with employee and their manager.
- Partner with HR to review status of cases and develop legally sound strategies for mutually beneficial resolution. Facilitate communications with employee, manager, HR staff and disability carrier.
- Track and maintain employee hours/days taken in leave of absence module in ADP payroll system. Work closely with Payroll department to ensure accurate pay for employees on leave and coordinate benefit premium payments from employees.
- Maintain current and organized leave case files and reports.
- Act as liaison between the Company and disability carrier to ensure STD/LTD claims are managed accordingly. Identify and resolve issues as needed.
- Assist in creation and facilitation of leave administration and workers' compensation training programs.
- May assist with administration of other areas in benefits department as needed.
- Collaborate, coordinate, and communicate across disciplines and departments.
- Demonstrate commitment to Company's Core Competencies and values held within.
- Please note due to the exposure of PHI sensitive data this role is considered to be a High Risk Role.
- The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
COMPENSATION The salary range for this position is $55-65K. Specific offers take into account a candidate's education, experience and skills, as well as the candidate's work location and internal equity. This position is also eligible for health insurance, 401k and bonus opportunity.
REQUIREMENTS Minimum High School diploma; and 3 years of Human Resources experience
Minimum 3 years leave administration experience; benefits administration helpful
Knowledge of applicable federal and state laws pertinent to benefits administration including FMLA, ADA, ERISA, HIPAA, Worker's Comp, etc.
Ability to use software and peripherals related to performance of job responsibilities
Ability to work independently as well as team environment
Strong communication, process management, analytical, decision making, organizational and time management skills
Ability to demonstrate commitment to excellent customer service and follow through
Ability to produce reports and correspondence
Ability to effectively present information and respond to questions from internal and external customers
Ability to be flexible and creative in problem solving and identifying program improvements
Individual in this position must be able to work in a standard office environment which requires sitting and viewing monitor(s) for extended periods of time, operating standard office equipment such as, but not limited to, a keyboard, copier and telephone
BENEFITS We realize that our employees are instrumental to our success, and we reward them accordingly with very competitive compensation and benefits packages, an incentive bonus program, as well as recognition and awards programs. Our work environment is friendly and supportive, and we offer flexible schedules whenever possible, as well as a wide range of live and web-based professional development and educational programs to prepare you for advancement opportunities.
Your benefits will include: - Medical, dental and vision coverage with low deductible & copay
- Life insurance
- Short and long-term disability
- Paid Parental Leave
- 401(k) + match
- Employee Stock Purchase Plan
- Generous Paid Time Off - accrued based on years of service
- WA Candidates: the accrual rate is 4.61 hours every other week for the first two years of tenure before increasing with additional years of service
- 10 paid company holidays
- Tuition reimbursement
- Flexible Spending Account
- Employee Assistance Program
- Summer Hours
- Sick time benefits - for eligible employees, one hour of sick time for every 30 hours worked, up to a maximum accrual of 40 hours per calendar year, unless the laws of the state in which the employee is located provide for more generous sick time benefits
EEO STATEMENT Claritev is an Equal Opportunity Employer and complies with all applicable laws and regulations. Qualified applicants will receive consideration for employment without regard to age, race, color, religion, gender, sexual orientation, gender identity, national origin, disability or protected veteran status. If you would like more information on your EEO rights under the law, please Link available when viewing the job .
APPLICATION DEADLINE We will generally accept applications for at least 15 calendar days from the posting date or as long as the job remains posted.