Team Lead Absence Management

UPMC Health Plan and Workpartners is hiring a Team Lead Absence Management. 

The Team Lead, Absence Management is responsible for workflow of five or more absence professionals. The Team Lead will provide support and assistance to administer absence management programs, with an emphasis on delivering an exceptional customer experience to absence clients. Team Lead will seek performance improvements and ensure compliance through periodic quality review audits and metric review. Team lead will be a subject matter expert and resource for employees, supporting absence management programs and support to new employees during onboarding. Team Lead works directly with the supervisor to manage daily operations within the department and meet all departmental goal and objectives. Position maintains a high level of interaction with internal departments to develop an integrated absence management program. Additionally, Team Lead should be able to fulfill all the major duties of an Absence Specialist.

Responsibilities:

• Team Lead supports leadership and administration of all leave requests to ensure quality customer service for all Work Partners’ clients, while maintaining a working caseload, in coordination with customer policy. Support staff performance indicators through feedback, recommendations and development of action plans to meet customer service standards. Monitor case assignments, overdue ToDos and other key performance metrics. Identify outliers and address performance gaps. Ensure program compliance through periodic quality review audits. Maintain reporting to identify root cause of potential or existing performance problems. Assist in the development/enhancement of policies and procedures. Monitor and refine workflows to facilitate communication and teamwork between departments. 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. Participate in interviewing, hiring and training of new team members. Assist with the counseling process as requested. Assists in the identification of recommendations to positively impact the efficiency and quality of service delivery. Provide mentoring support to peers when dealing with challenging leave issues such as extended time away from work, complex medical diagnoses and recertification issues.
• Assist in the generation of client on demand reports such as open case lists and reports of employee usage. Support Supervisor in the analysis of absence patterns and issues to be reviewed with clients. Provide recommendations to address opportunities. Participate and develop on demand client trainings to facilitate ongoing understanding and knowledge of the regulations and client specific policies. Participate in team meetings and provide information to team members in a timely manner. Provide backup and team support during supervisor’s absence. Assist in the resolution of difficult claim requests; provide subject matter expertise on federal regulations and accept escalated calls from team members. Maintain a positive work environment through employee recognition and interaction. Support department productivity by assisting other employees with casework. Demonstrate consistent productivity with casework and project work as assigned.
• Workload Assistance: Provide detailed case documentation to ensure continuity when specialist returns from absence. Follow all client-specific protocols and program expectations through use of documentation. Support all types of polices and processes including FMLA, Military, Company specific leaves, PFML, STD, Salary Continuance, etc.), in addition to supporting HR Professionals, Payroll/HRIS updates, employee/manager communications and case tracking. Track employee leave of absences as reported via web, fax, phone and e-mail. Coordinate the leave process; verify eligibility, determine leave approval, coordinate applicable client leave polices including integration with state leave laws, and support the return-to-work process. Perform initial evaluation via phone with employee and employer for assigned cases. Review estimated disability duration and return to work potential. Reviews medical documentation in order to analyze, investigate and make decisions for the approval of benefits on initial, ongoing and re-opened claims Responsible for all communications with the employee, employee’s manager, human resources and all integrated partners e.g., disability management coordinator in the event of transitional return to work. Monitor Disability guidelines and when disability durations fall outside of standards, review claims as appropriate with treating physician, clinical case manager or medical director. Provide consistent customer service to internal customers and employees through timely responses to all inquiries, telephone calls, e-mails and case follow-ups, while delivering on service commitments. Reviews claims in accordance with guidelines established by the client, state and federal regulations, as appropriate. Support outbound employee absence related calls.