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Short Term Disability Supervisor

  • Job ID: 664268061
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Disability Specialists
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $30.17 to $50.94 / hour

Description

Purpose:
UPMC Workpartners' Disablity Specialists Department is actively seeking a Supervisor of Short Term Disability!

This role will provide leadership, guidance and direction to administer self-insured STD programs for Work Partners clients, with an emphasis on ERISA compliance. Manage the workflow of their staff and ensure compliance through periodic quality review audits. Provide management oversight for the intake and administration of all STD claims to ensure quality customer service for all Work Partners' clients. Have knowledgeable information resource and liaison between all parties involved in client's disability programs and work closely with all of the Health Plan's programs in developing an integrated health and productivity delivery system.

The role is physically remote for the duration of the COVID-19 pandemic before being re-assessed. 

Responsibilities:

 

  • Analyze reported STD claim requests to make determinations based on plan design and/or company policies within state and federal regulations. Supervisor will ensure that on-going claim management is within client company service standards and industry best practices.
  • Monitor cost containment and quality standards consistent with internal goals and budgets.
  • Establish internal controls to ensure all claim adjudications are within established time frames and guidelines.
  • Maintain a positive work environment that supports high performing teams and rewards people based on performance. Handle high cost/sensitive claims.
  • Develop, implement and monitor performance indicators for staff. Provide feedback, training and corrective action as needed.
  • Serve as the escalated communication link for all parties involved in STD program including employees, client company representatives, health care providers, union officials, and other UPMC or Work Partners professionals.
  • Provide training to staff to ensure that all protocols are followed under legal, regulatory and client corporate policy.
  • Oversee the implementation of new customers and effective integration with other Work Partner programs or other client vendors.
  • 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.
  • Review and approve case owner recommendations for Matched Specialty Physician Peer Review referrals for complicated denials.
  • Promote professional development of program staff to maintain competency and compliance with legal, regulatory and corporate policy.
  • Provide management oversight for overall program performance and day to day service delivery.
  • Oversee the intake and administration of all STD claim requests to ensure quality customer service for all Work Partners' clients.
  • Consult with clients on case scenarios where the plan or policies are silent or unclear to document the fiduciary's guidance and set work rules for future claim handling.
  • Proactively identify opportunities and make recommendations for enhancements to processing and report systems and procedures.
  • Help prepare communications, training and resource materials for staff and clients.
  • Assist the Sr. Manager of Disability Services in forecasting staffing needs and recommending administrative efficiency strategies.

 

Qualifications

  • Bachelor's degree required or equivalent experience
  • Two (2) years of supervision/management experience required
  • Five (5) years demonstrated success in disability claim management administration required
  • Three (3) years experience in short term disability claims administration required

Experience managing compliance issues with various state and federal laws that impact disability management such as ERISA, ADA, FMLA and FLSA.Self-motivated and have the ability to work independently and handle multiple priorities and deadlines simultaneously with minimal guidance.Excellent leadership and communication skills.Strong problem solving, analytical and decision making skills.Customer service oriented with the ability to handle emotionally charged situations.Time management skills, ability to prioritize and identify critical tasks that deliver highest impact.Ability to exercise sound judgment and act in a decisive manner to minimize risk to the organization/clients.Excellent analytical, troubleshooting and problem-solving skills; sense of urgency, responsiveness and judgment to make effective decisions is required.Understanding of integrated disability and absence management is preferred.Ability to work effectively across a large, highly matrixes and dynamic organization.Willing to learn new technical, business and system skills.Flexible and effective at exchanging ideas and managing the creative ideas of others to improve results.Computer skills/literacy required.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct