Leave of Absence and Workers Comp Specialist

Summary:
The essential functions of this position include but are not limited to: Administers the Leave of Absence programs including Family Medical Leave Act (FMLA), Non FMLA, Military, Personal and Educational leaves, as well as requirements under the Americans with Disabilities Act. Educates and counsels managers and employees on all aspects of Leaves of Absence, including Family Medical Leave Act and Americans with Disabilities Act (ADA) regulations and requirements. This position is also responsible for handling and investigating employee incidents, and compilation of regulatory reporting requirements for MyMichigan Health. Additional data evaluation and reporting are submitted to managers/directors and various committees on a monthly, quarterly and annual basis and will be completed in collaboration with the Senior Workers Compensation Specialist.

Responsibilities:
(25%)* Investigates employee incidents in collaboration with the Employee Health Department and Department Managers so corrective action can be taken if appropriate and reoccurrence of risk can be reduced. Administers Leave of Absence (LOA) programs, including FMLA and ADA, in accordance with State and Federal Guidelines and MyMichigan Health's policies. Updates LOA and ADA policies as needed.

 

(25%)* Directs employees on Workers Compensation claims process. Administers LOA program for assigned subsidiaries. Enters FMLA and non FMLA applications into Infor medical leave for hours used and medical documentation needed. Enters information on leaves of absence into Infor. Communicates to managers and HR on leave status of employees. Communicates medical information to appropriate department for Short Term Disability (STD) pay. Reviews and approves STD report prior to report going to pay management. Prepares and sends appropriate communication and paperwork to employees, managers and other affected individuals in a timely manner and as required by law or policy.

 

(25%)* Exchanges information with Third Party Administration (TPA) and nurse case managers so that claim is processed within the legal requirements. Makes recommendations/directing TPA and nurse case managers in handling Workers Compensation claims.

Leads and Administers ADA program for assigned affiliates. Determines if there is an ADA request and initiates the interactive process. Notifies manager and other key people as to request for ADA accommodation. Leads the interactive process between employee, manager and Human Resources representative, if needed, for determining ADA accommodations. Documents and communicates outcomes of the process to appropriate personnel in a timely manner and as required by law or policy.

 

(25%)* Under the guidance of the Senior Workers Compensation Specialist approves/denies recommendations from TPA such as Independent Medical Exam (IME), surveillance, medical management, Voc Rehab, outplacement, etc.

Collaborates with other system leave specialists, Human Resources (HR) and other system team members for FMLA and ADA policies and procedures as well as case management. Actively participates in teams, groups and meetings.

 

OTHER DUTIES AND RESPONSIBILITIES

 

Serves as a resource person for managers and employees on ADA, FMLA and LOA issues. Provides on site training as needed. Acts as a liaison between Employee Health, Human Resources & Risk Management concerning FMLA and medical leaves of absence, including potential ADA issues or accommodations.

 

Provides a confidential and trusting relationship with employees and managers.

 

Compiles data and prepares and distributes quarterly statistical reports for all system Leaves of Absence.

 

Works with other system leave specialists to identify system needs and implements improvements as they relate to leaves of absence and ADA. Designs and updates system processes as needed. Assists department manager and team with other duties as assigned.

 

Calculates and compiles OSHA reportable injuries and illnesses so that MyMichigan Health is compliant with legal requirements. Gathers information on incidents, claims and claimants from various departments and individuals. Directs employees/managers/supervisors on workers compensation claims process.

 

Investigates and identifies transitional work positions for injured employees.

 

MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft Windows. An employee may be required to participate in further learning opportunities offered by MyMichigan Health.

Certifications and Licensures:
N/A

Required Education:
Bachelor's degree in a related field is required.

Other Information:
EXPERIENCE, TRAINING AND SKILLS

 

Three years' experience working within human resources, benefits and/or leaves of absence and disability management preferred.

 

Certified Worker's Comp Professional Certificate preferred.

 

Previous FMLA and ADA experience is preferred.

 

Working knowledge of office and insurance/billing/policies, practices and procedures acquired through 5 years experience in a healthcare environment is preferred.

 

Thorough knowledge of computerized incident and claims software including report creation and generation and working knowledge of Internet for research purposes are both preferred.

 

Problem solving techniques/expertise; Excellent human relations, customer service and communication skills are required.

 

Interpersonal skills needed to communicate successfully with individuals and groups and interact with people at all levels to articulate ideas and concepts in a clear and understandable manner are required.

 

Mandatory Occupational Safety and Health Administration (OSHA) training must be completed annually according to the Exposure Control Plan.

 

Working knowledge of State and Federal FMLA, ADA, Health Insurance Portability and Accountability Act (HIPAA) and related regulations is required.

 

Must uphold the highest level of confidentiality.

 

Knowledge of medical terminology is preferred.

 

Experience with Infor database development and management, as well as Excel report writing, is preferred.

 

PHYSICAL/MENTAL REQUIREMENTS AND TYPICAL WORKING CONDITIONS:

 

Exposure to stressful situations, including those involving public contact, as well as, trauma, grief and death.

 

Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position.

 

Is able to move freely about facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description.

 

Overall vision and hearing is necessary with or without assisted device(s).

 

Frequently required to sit/stand/walk for long periods of time. May require frequent postural changes such as stooping, kneeling or crouching.

 

Some exposure to blood borne pathogens and other potentially infectious material. Must follow MyMichigan Health bloodborne pathogen and TB testing as required.

 

Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake.

 

Overall dexterity is required including handling, reaching, grasping, fingering and feeling. May require repetition of these movements on a regular to frequent basis.

 

Physical Demand Level: Light. Must be able to occasionally (0 33% of the workday) lift or carry 11 20 lbs., frequently (34 66% of the workday) 10 lbs. and or Walk/Stand/Push/Pull of Arm/Leg controls.

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