Disability Leave Management Consultant (FMLA)

Job Summary:

The Disability Leave Management Consultant (FMLA) is responsible for analyzing, evaluating, and overseeing the determination of employee leave benefits including Family Medical Leave Act (FMLA), sick pay, and Short-Term Disability claims. This position works closely with the Southern Company FMLA Management Center and supports the achieving of a timely and medically appropriate return to work for employees. As a subject matter expert, the Senior Disability Specialist demonstrates advanced capabilities in all areas of sick pay, FMLA, and short-term disability case management. This role ensures accurate reconciliation and maintenance of time records for leaves of absence, including FMLA and workers' compensation, while collaborating with timekeepers, the technology organization, payroll, and external vendors to uphold data integrity and compliance with company policies.  This role also acts as the Workers' Compensation employer liaison with the Third-Party Administrator (TPA) and internal stakeholders for commercially insured states. 

Job Duties & Responsibilities:

• Collaborate with the Leave management center vendor for FMLA and Short-Term Disability leaves.
• Oversight to employees' eligibility and benefit levels for FMLA, sick pay, and short-term disability cases.
• Serve as a liaison between the Leave vendor, Southern Company DM Medical Services teams, and line-management.
• Support reporting of short-term disability cases to the long-term disability insurer within specified time frames.
• Maintain reporting standards and present case reviews to the Disability Management Medical Services groups.
• Act as a subject matter expert in all areas of sick pay, FMLA, and short-term disability.
• Work with LTD Carrier and company DM Medical Services groups to prepare comprehensive evaluations for long-term cases.
• Assist as needed to coordinate leave claims management and return-to-work efforts with the Leave management vendor.
• Participate as needed in reviews of pending claims and return-to-work strategies with Human Resources, Legal, relevant management employees, and the Leave management center vendor.
• Partner with the company Disability Management (DM) Medical Services groups.
• Track loss experience and identify trends and underlying issues related to leave management.
•  Evaluate and recommend Best Practice service standards.
• Regularly review the integrated leave management vendors’ efforts to ensure efficiency, cost-effectiveness, and compliance with contracts.
• As needed, demonstrate strong command of all disability issues and serve as a subject matter expert on all areas of leave management. 
• Provide training and support to timekeepers and other relevant staff on leave record management. 
• Ensure compliance with company policies and legal requirements related to leave management, workers compensation claims, and FMLA Claims.
• Serve as the primary liaison for inquiries and issues related to the leave management center and workers’ compensation claims within the commercially insured programs of Southern Company subsidiaries.
• Oversee, audit, and correct discrepancies on leave of absence records, including FMLA, sick leave, occupational injury, and other types of leave.
• Communicate with external vendors (e.g., Sedgwick, Everest National Ins. Co., etc.) to resolve discrepancies and ensure records are up to date. 
• Coordinate and document employer processes for handling commercially insured workers’ compensation claims. 
• Obtain documentation requested by external adjuster(s) for state and federal workers’ compensation form filings. 
• Collaborate with nurse case manager(s) and management on return-to-work for commercially insured workers’ compensation claims.
• Collaborate with Southern Company Risk Management on contractual agreements and expectations with commercially insured insurance carrier and TPA. 
• Poster coordinator for state/federal workers compensation, leave, and other disability compliance laws in multiple states.
• Maintain confidentiality and manage sensitive information with discretion. 

Job Qualifications:

• Bachelor's degree preferred.
• At least 3 years of experience in claims management, focusing on FMLA, workers compensation, and Short-Term Disability claims required
• Ideal candidate will have experience with Oracle or HRIS
• Strong knowledge in handling cases from simple to complex / catastrophic.
• Demonstrated analytical thinking in complex situations and recognition of multiple connections to reach appropriate case decisions.
• Excellent interpersonal, oral, and written communication skills.
• Strong ability to strategize, prioritize, and negotiate; demonstrate confident decisiveness and sound judgment.
• Customer-focused and approachable, with a high level of comfort dealing with all levels of management.
• Problem-solving skills and ability to make timely decisions.
• Team-oriented and able to work effectively in a teamwork environment.
• Goal-oriented and accountable for work product.
• Capable of managing complex claims from inception through trial when necessary.
• Dedicated to maintaining quality and excellence by consistently complying with Best Practices service standards.
• Willing to pursue ongoing education to stay informed about the latest industry developments, statutory laws, and trends.
• Critical thinker and effective problem solver, skilled at identifying issues, securing relevant information, critically evaluating situations, and presenting sound factual reports.
• Ability to analyze complex issues, identify trends, and recommend simple, relevant solutions.
• Confident and skilled to work independently as well as in a team environment.
• Flexible and adaptable, able to learn new plans, vendors, and systems quickly.
• Demonstrates effective project management skills, able to multitask seamlessly.
• Exhibits exceptional customer service focused on speed, accuracy, and ownership.
• Demonstrates effective communication and presentation skills.
• Experience developing strong, successful working relationships to drive efficiency and effectiveness.
• Demonstrates behaviors consistent with the Southern Company culture: Unquestionable Trust, Superior Performance, and Total Commitment.
• Proficient with Microsoft Excel, Word, and PowerPoint.
• Occasional travel may be required, and the applicant must be able to work flexible hours to accommodate different time zones, if necessary.