Supervisor, Absence Management

UPMC Health Plan and Workpartners is hiring a Supervisor, Absence Management. This role will predominantly work remotely. 

The Supervisor Absence Management will provide leadership, guidance and direction to administer absence management programs, with emphasis on centralized FMLA administration and ERISA compliance. The supervisor will manage the workflow of their staff; and ensure compliance through periodic quality review audits. This position will provide management oversight for the intake and administration of all leave requests to ensure quality customer service for all Workpartners clients. The supervisor will be a knowledgeable information resource and liaison between all parties involved in client absence programs and work closely with the vocational and workers’ compensation units in developing an integrated leave management program. 

Responsibilities:

• Makes recommendations for FMLA second and third opinions when indicated Workpartners clinical staff. Helps prepare communications, training and resource materials for staff and clients. Monitors cost containment and quality standards consistent with internal goals and budgets.
• Provide subject matter expertise during the program development to interpret regulations and client-specific benefits and policies to ensure the accuracy of system configuration and claim processing. Research and review case law and apply knowledge and information to unusual case scenarios to determine eligibility of complex absence requests with legal input as necessary.
• Proactively identifies opportunities and makes recommendations for enhancements to processing and reporting systems and procedures
• Assist the Director of Disability Services in forecasting staffing needs and recommending administrative efficiency strategies.
• Establishes internal controls to ensure all leave adjudications are within established time frames and guidelines. Provides training to staff to ensure that all leave protocols are followed under legal, regulatory and client corporate policy.
• Promotes professional development of program staff to maintain competency and compliance with legal, regulatory and corporate policy. Maintains a positive work environment that supports high-performing teams and rewards people based on performance.
• Operational LeadershipDevelops, implements and monitors performance indicators for staff. Provides feedback, training and corrective action as needed.
• Serves as the escalated communication link for all parties involved in absence program including employees, client company representatives, health care providers, union officials, and other UPMC or Workpartners professionals.Identifies absence program issues and trends and collaborates with customers to ensure processes are in place to continue to meet their needs in a changing environment.
• Consult with clients on case scenarios where the plan or policies are unclear to document the guidance and set work rules for future claim handling. Identify client program issues and trends and collaborate with customers to ensure processes are in place to continue to meet their needs in a changing environment. Oversees the implementation of new customers and effective integration with other Workpartners programs or other client vendors. Help prepare communications, training and resource materials for staff and clients.
• Client SupportOversee the intake and administration of all leave and disability claim requests to ensure quality customer service for all Workpartners clients. The program staff will analyze reported absence requests to make determinations based on company policies within state and federal regulations. The supervisor will ensure that ongoing claim management meets client company service standards and industry best practices.
• Provide management oversight for overall program performance and day-to-day service delivery.