At Claritev, we pride ourselves on being a dynamic team of innovative professionals. Our purpose is simple - we strive

to

bend the cost curve in healthcare

for all. Our dedication to service excellence extends to all our stakeholders – internal and external - driving us to consistently exceed expectations. We are intentionally bold, we foster innovation, we nurture accountability, we champion diversity, and empower each other to illuminate our collective potential. Be part of our amazing transformational journey as we optimize the opportunity towards becoming a leading technology, data, and innovation voice in healthcare. Onward and Upward!!!

JOB SUMMARY:

This position is responsible for leave of absence administration and case management. Provide exemplary customer service to employees, management and HR business partners.

JOB ROLES AND RESPONSIBILITIES: Interpret and administer leave of absence and paid sick time programs/policies in accordance with applicable federal and state laws (FMLA, ADA, USERRA, Pregnancy Discrimination Act, workers' comp., etc.). Ensure compliance with regulations when processing leave claims. Stay current with latest legislative changes and be able to identify overlapping laws to determine those that applicable each leave case. Manage all aspects of leave claims; independently approve/deny requests based on relevant medical information. Investigate and review information submitted for claim/case to ensure compliance with policies. Ensure HIPAA and privacy guidelines are effectively executed. Establish and maintain all communications with employees on leave and coordinate return to work process with employee and their manager. Partner with HR to review status of cases and develop legally sound strategies for mutually beneficial resolution. Facilitate communications with employee, manager, HR staff and disability carrier. Track and maintain employee hours/days taken in leave of absence module in ADP payroll system. Work closely with Payroll department to ensure accurate pay for employees on leave and coordinate benefit premium payments from employees. Maintain current and organized leave case files and reports. Act as liaison between the Company and disability carrier to ensure STD/LTD claims are managed accordingly. Identify and resolve issues as needed. Assist in creation and facilitation of leave administration and workers' compensation training programs. May assist with administration of other areas in benefits department as needed. Collaborate, coordinate, and communicate across disciplines and departments. Demonstrate commitment to Company's Core Competencies and values held within. Please note due to the exposure of PHI sensitive data -- this role is considered to be a High Risk Role. The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.

JOB SCOPE : The incumbent serves as the subject matter expert for leave of absence programs who works independently, relying on experience and judgment to administer leave cases. Assignments are varied in nature requiring independent thinking and ingenuity. The incumbent performs a variety of tasks with some being complex and will escalate most complex issues to a higher level. Works under the general direction and leadership of Benefits and legal department.