IntegratedADMSpecialist

TELUS Health is empowering every person to live their healthiest life. Guided by our vision, we are leveraging the power of our leading edge technology and focusing on the uniqueness of each individual to create the future of health. As a global-leading health and well-being provider – encompassing physical, mental and financial health – TELUS Health is improving health outcomes for consumers, patients, healthcare professionals, employers and employees.

TELUS Health is empowering every person to live their healthiest life. Guided by our vision, we are leveraging the power of our leading edge technology and focusing on the uniqueness of each individual to create the future of health. As a global-leading health and well-being provider – encompassing physical, mental and financial health – TELUS Health is improving health outcomes for consumers, patients, healthcare professionals, employers and employees.

TELUS Health is empowering every person to live their happiest life. Guided by our vision, we are leveraging the power of our leading edge technology and focusing on the uniqueness of each individual to create the future of health. As a global-leading health and well-being provider – encompassing physical, mental and financial health – TELUS Health is improving health outcomes for consumers, patients, healthcare professionals, employers and employees.

Our team and what we’ll accomplish together

The Integrated ADM Specialist serves as the primary subject matter expert and facilitator for the Americans with Disabilities Act (ADA) interactive process as well as the Pregnancy Workers Fairness Act (PWFA) in addition to overseeing, managing, processing, and adjudicating FMLA, State, and company specific leaves, as well as straightforward and complex STD claims; to determine benefits due pursuant to an STD plan: and to ensure the ongoing processing of claims.

Must analyze reported Family Medical Leave (FMLA) requests; to make determinations based on Federal and State regulations; to communicate clearly with clients and claimants on all aspects of the claims process; and to ensure that claim management processes are followed per our best practices and client specific steps. With respect to the ADA and PWFA, this role is responsible for guiding employees and clients through the reasonable accommodation process, mitigating legal risk, and ensuring a seamless integration between short-term disability (STD), FMLA/leaves, and ADA requirements

Manage and process FMLA (and other Federal leaves as applicable) Military leaves, State leaves, company specific and STD claims. With regard to FMLA, will manage all DOL category claims; including re-certifications and the 2nd and 3rd opinion processes. Manage all ADA and PWFA claims by advising clients on options for reasonable accommodation and making recommendations regarding the best approach for managing such claims as it relates to the ADA and PWFA.

Conduct case assessments, contacting the employee and their manager / HR by telephone or email, to explain the leave management process, employee accountabilities, and gather information for assessment purposes. Develop and document an understanding of the situation and the factors supporting, as well as inhibiting, a successful return to work for the employee against the essential job functions and undue hardships for the client organization.

Review all relevant information and consult with appropriate medical resources as required (nurse consultants, health professionals, supervisory team) to confirm decision and recommendations on FMLA, State, Company specific leaves, STD and ADA cases. Analyzes FMLA medical certifications and other medical documentation and ensures claim…