Overview:
At St. Luke's, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke's is truly a great place to work.
What to Expect
The HR Case Manager is responsible for the investigation and administration of SLHS basic to intermediate leave of absence (LOA) claims. This role assists employees through the statutory and plan rules including working with and referring to internal and external resources.
* Investigates and administers basic to intermediate claims under general supervision. Verifies compensability through research of plan, statutory rules, case law, contact with employees, medical providers, employer, in-house counsel and/or external counsel; makes determinations regarding Benefits.
* Communicates benefits and/or decisions within established timeframes.
* Maintains claim files and updates with information from employer, employee and medical providers.
* Pays appropriate benefits on a timely basis in accordance with the applicable Plan and/or statutory regulation.
* Reports on claims issues to key stakeholders, including, but not limited to: employee, medical providers, legal counsel, and/or leadership.
* Collaborates with Employees, Department leadership, Employee Relations and/or external vocational rehabilitation consultants when an employee is released to return to work to determine available work within SLHS and/or the community.
* Collects, analyzes and presents data.
* Ensures compliance with applicable rules, regulations and policies.
* Provides day-to-day advice, interpretation, and support to client departments regarding the application of human resources policies, guidelines, procedures, and best practices.
* Performs other duties and responsibilities as assigned.
Minimum Qualifications
* Bachelors + 0 years of experience OR
* Associates + 2 years of experience OR
* HS Diploma/GED + 4 years of experience
Preferred Qualifications
* HR case management experience/leave of absence experience
Responsibilities:
The Case Manager is responsible for the investigation and administration of SLHS basic to intermediate leave of absence (LOA) and/or Long Term Disability (LTD) claims. This role assists employees through the statutory and plan rules including working with and referring to internal and external resources.
* Investigates and administers basic to intermediate claims under general supervision. Verifies compensability through research of plan, statutory rules, case law, contact with employees, medical providers, employer, in-house counsel and/or external counsel; makes determinations regarding Benefits.
* Communicates benefits and/or decisions within established timeframes.
* Establishes and maintains adequate reserves to cover estimated cost of claims; provides reports on established reserves.
* Maintains claim files and updates with information from employer, employee and medical providers. Continuously evaluate need for nurse case manager, independent medical providers, panel evaluations, etc.
* Calculates earnings; pays appropriate benefits on a timely basis in accordance with the applicable Plan and/or statutory regulation.
* May calculate annual review of Indexed Pre-disability Earnings and Monthly Benefit Rates on Total Disability Claims and communicates out accordingly.
* Investigates and seeks third party recovery on claims, as appropriate. Analyze other opportunities for offsets of Other Income Benefits and make referrals to external resources as appropriate.
* Reports on claims issues to key stakeholders, including, but not limited to: employee, medical providers, legal counsel, and/or leadership.
* Collaborates with Employees, Department leadership, Employee Relations and/or external vocational rehabilitation consultants when an employee is released to return to work to determine available work within SLHS and/or the community.
* Collects, analyzes and presents data.
* Ensures compliance with applicable rules, regulations and policies.
* Provides day-to-day advice, interpretation, and support to client departments regarding the application of human resources policies, guidelines, procedures, and best practices.
* Performs other duties and responsibilities as assigned.
Qualifications:
* Education: Bachelors degree or experience in lieu of degree
* Experience: 0 years experience
* Licenses/Certifications: None
Share this job:
Share this Job
