This position has responsibility to ensure short and long term disability leaves, Family Medical Leave of Absence leaves, Americans with Disabilities Act requests, and worker’s compensation claims are being provided in accordance with AmeriHealth Caritas policies. Responsibilities include coordination and vendor management with outsourced leave providers, management of escalated claims, liaison with associates and business partners, consultation with internal and external legal counsel, associate advocacy and communication, management of vendor integrations for proper tracking and payment of leaves, and managing the daily activities and advising the leave team on complex matters.

• Provide daily management, guidance and training on all leave related matters to the leave specialists.
• Responsible for the vendor management of leave, disability and worker’s compensation providers.
• Manage escalated disability, leave and worker’s compensation claims to ensure benefits are provided in accordance with AmeriHealth Caritas policies.
• Administer worker’s compensation claims to ensure appropriate resolution.
• Manage litigated worker’s compensation claims to facilitate timely resolution with outside legal counsel and outsourced venders.

Coordinate communications/interactions:

• Associate Relations: escalated cases and medical accommodations
• Legal: prepare settlement recommendation for management approval and compile information for case files for legal (internal/external)/subpoenas
• Talent Acquisition: displaced employees returning from leave
• Human Resources Business Partners (HRBPs): complex problem resolution, benefit education and trend analysis
• HRIS Integrations: benefit delivery, status changes, status updates, and problem resolution in HRIS
• Payroll Integrations: advise on payroll for associates on leave, resolve payroll matters
• Associates: escalated matters and inquiries relating to disability, workers’ compensation, ADA, and leave issues
• Facilities: safety/worker’s compensation and ergonomic issues
• Management Team: provide support on return to work status questions regarding job protection, workers’ compensation claims, transition from active employment, questions relating to absence and disability
• Coordinate the management of the central mailbox and address escalated issues from clients and providers.
• Administer the processing of separations and terminations from company for associates on leave.
• Coordinate accommodations resulting from a leave, coordinate return to work efforts and involve additional parties when necessary.
• Ensure AmeriHealth Caritas is compliant with all state and local regulatory requirements including coordination of mandated filings.
• Create and maintain all leave related information on company website and develop communication materials.
• Deliver management training on leave administration.

Education/ Experience:

• Bachelor’s Degree in HR, business or related field is preferred.
• 5 to 10 years of leave of absence, worker’s compensation, and disability experience or other relevant transferable skills related to benefits or disability management is required.
• At least 3 years' experience leading a team of Associates, along with experience managing a Leave of Absence program.
• Experience with Payroll and HRIS systems – preferably ADP and Oracle PeopleSoft – is a plus.
• Proficiency in Microsoft Office, including Word, Excel and Outlook is required.
• PHR or CEBS certification is preferred.
• Must be able to work independently and work well on internal and external teams.
• Must demonstrate flexibility and have experience working with different types of organizations including vendors, consultants, and clients.
• Proven verbal and written communication skills.
• Must be self-directed and able to handle large, concurrent job duties with minimal supervision.
• Must be extremely customer-service oriented, organized, detailed, able to multi-task, work under pressure, meet deadlines, be a self-starter, and be able to assist where and when needed.

NOTE: AmeriHealth Caritas utilizes a hybrid work environment with associates working from home two days a week, and in the office three days a week. The functions of this position will be performed onsite at our offices located at 3875 West Chester Pike, Newtown Square, 19073.