disability case manager

UC San Diego Health

<div><div>Greenwich Drive
<br>
6256 Greenwich Drive, San Diego, CA 92122, United States
</div><div></div><div><div><div><div><div>Payroll Title:</div>
ENTERPRISE RISK MGT ANL 3
<div>Department:</div>
HEALTH HUMAN RESOURCES
<div>Hiring Pay Scale</div>
$78,000 - $110,000 / Year
<div>Worksite:</div>
Greenwich Drive
<div>Appointment Type:</div>
Career
<div>Appointment Percent:</div>
100%
<div>Union:</div>
Uncovered
<div>Total Openings:</div>
1
<div>Work Schedule:</div>
Days, 8-Hour Shifts, Monday - Friday
</div></div></div><div><div><div><h2 class="jobSectionHeader"><b>#139261 Disability &amp; Accommodation Case Manager - Hybrid</b></h2>
<b>Filing Deadline: Mon 4/27/2026</b></div><div>
</div><div></div><div><br>
<b>UC San Diego values and welcomes people from all backgrounds. If you are interested in being part of our team, possess the needed licensure and certifications, and feel that you have most of the qualifications and/or transferable skills for a job opening, we strongly encourage you to apply.</b><br>
<br>
</div><div><div><p><i>UCSD Layoff from Career Appointment</i>: Apply by 04/15/26 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.</p>
<p><i>Reassignment Applicants</i>: Eligible Reassignment clients should contact their Disability Counselor for assistance.</p></div><div>
<p><b>This position will work a hybrid schedule which includes a combination of working both onsite (3 days) at Greenwich Dr. and remote (2 days).</b></p></div><h1 class="jobSectionHeader"><b>
DESCRIPTION</b></h1><p>
Under the direction of the Disability Management and Workers' Compensation Supervisor, this position provides support and guidance to employees, faculty, and departments for occupational and non-occupational injuries and illnesses by administering the insurance programs to facilitate maximum recovery, identifying risk exposures, recommending strategies to reduce or eliminate risks. This position impacts constituencies at all levels of the organization.
</p><p>This role is responsible for managing the entire process, to include but not limited to: intake and scoping of requests/claims, consultation with employees and managers, communication with providers and medical professionals, interactive process, complex claim administration, and benefits coordination in accordance with federal and state law as well as organization policies and guidelines. The position interfaces effectively with other departments in HR, Health and Safety, Payroll/Timekeeping, Risk Management, Legal, and related contacts internal and external to the University to achieve desired goals. The position also designs, develops and presents training presentations to clients, and assists in program administration by analyzing complex risk metrics to assist with program enhancements.
</p><h1 class="jobSectionHeader"><b>MINIMUMQUALIFICATIONS</b></h1><ul><li><p>
Seven years of related experience, education/training, OR a Bachelor&rsquo;s degree in related area plus three years of related experience/training.</p></li><li><p>
Demonstrated comprehensive knowledge of California workers' compensation claims management; experience with either a third-party claims administrator, insurer or a large employer.</p></li><li><p>
Knowledge of the ADA, FMLA, CFRA, EEOC/DFEH and other related regulations and provisions.</p></li><li><p>
Proven conceptual and oral communication skills to explain related University and location policies, procedures, and collective bargaining agreement articles.</p></li><li><p>
Working knowledge of medical terminology and medical reports and their respective implications for reasonable accommodation and placement.</p></li><li><p>
Ability to conduct job analyses and compare functional capacity to job requirements in order to recommend reasonable accommodations.</p></li><li><p>
Proven customer service orientation, active listening skills, and organizational skills while balancing significant caseloads.</p></li><li><p>
Experience in a large, fast paced and highly unionized environment handling a high case volume.</p></li><li><p>
Proven ability to communicate effectively, both orally and in writing, and use critical thinking and analytical skills to solve problems. Including the ability to clearly explain federal and state laws/regulations, University policies and procedures, and collective bargaining agreements language.</p></li></ul><h1 class="jobSectionHeader"><b>
PREFERRED QUALIFICATIONS</b></h1><ul><li><p>
Certified in California Workers&rsquo; Compensation, Certified Professional in Disability Management, Certified Rehabilitation Counselor, Certified ADA Coordinator.</p></li><li><p>
Experience in working in higher education or healthcare environment.</p></li><li><p>
Working knowledge of case management systems, PeopleSoft, and UCPath system.</p></li></ul><h1 class="jobSectionHeader"><b>
SPECIAL CONDITIONS</b></h1><ul><li>
Employment is subject to a criminal background check and pre-employment physical.</li></ul><div><p><i>
Pay Transparency Act</i></p><p>
Annual Full Pay Range: $71,600 - $127,400 (will be prorated if the appointment percentage is less than 100%)
</p><p>Hourly Equivalent: $34.29 - $61.02
</p><p>Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).</p></div></div><div></div><div><br>
</div><div></div><div><br>
<p><b>If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.</b><br>
<br>
<b>If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.</b></p><br>
<p>UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and dozens of outpatient clinics. We invite you to join our team!</p>
<p>Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.</p><p>
To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.</p><br>
<p></p>
<p>The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.</p><p>
For the University of California&rsquo;s Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination</p><p></p><p><br>
UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.</p>
<p>UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.<br>
</p><p></p><p><b>Misconduct Disclosure Requirement:</b> As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.
</p><p>a. &quot;Misconduct&quot; means any violation of the policies governing employee conduct at the applicant&rsquo;s previous place of employment, including, but not limited to, violations of policies prohibiting sexual harassment, sexual assault, or other forms of harassment, or discrimination, as defined by the employer. For reference, below are UC&rsquo;s policies addressing some forms of misconduct:
</p><p></p><ul><li>UC Sexual Violence and Sexual Harassment Policy</li><li>
UC Anti-Discrimination Policy</li><li>
Abusive Conduct in the Workplace</li></ul></div></div></div></div></div><p></p>
<br><div><h2 class="jobSectionHeader"><b>Job Details</b></h2>
<div><div>Date Posted</div>
04/13/2026</div></div><div></div>

Disability & Accommodation Case Manager - Hybrid

Koch

<div><p>*** Please Note: Candidates who can be hired with no Visa sponsorship requirements will be considered ***<br>
<br>
<b>Adult Case Manager:</b> OnPoint is seeking an energetic, organized, committed professional to fill the position of full-time Adult Case Manager. As an Adult Case Manager, you will be responsible for providing opportunities for individuals with an intellectual/developmental disability, mental health, substance use, or co-occurring disorder to experience full community participation in work, recreational, residential, and social settings.</p><p><b>
PAY RANGE/BENEFIT PACKAGE:</b></p><p>
Salary: starting at $55,181.18 up to $76,150.02 annually - placement above minimum salary is based on experience.</p><p><b>
OnPoint Benefits:</b></p><ul><li><p>
401(a) retirement: employer matching</p></li><li><p>
457 retirement</p></li><li><p>
Paid holidays</p></li></ul><p><b>
Benefits effective date of hire:</b></p><ul><li><p>
Medical insurance</p></li><li><p>
Dental insurance</p></li><li><p>
Vision Coverage</p></li><li><p>
Employer funding of Health Savings Account (up to elected deductible amount)</p></li></ul><p><b>
Employer Paid benefits:</b></p><ul><li><p>
Disability insurance</p></li><li><p>
Life insurance (up to $50,000)</p></li><li><p>
Paid Time Off</p></li></ul><p><b>
QUALIFICATIONS:</b></p><ul><li><p>
Bachelor&rsquo;s degree in social work, psychology, human services, or related field required.</p></li><li><p>
One year experience working with adults diagnosed with an intellectual /developmental disability or mental health disorder required.</p></li><li><p>
Community-based service delivery preferred.</p></li><li><p>
Knowledge of person-centered planning process preferred.</p></li><li><p>
Valid Michigan driver&rsquo;s license and auto insurance coverage or eligibility required.</p></li><li><p>
Exceptional written and verbal communication skills</p></li><li><p>
Function in a fast-paced and ever-changing environment.</p></li></ul><p><b>
GENERAL RESPONSIBILITIES:</b></p><ul><li><p>
Facilitate the person-centered planning process.</p></li><li><p>
Provide Case Management Services to individuals on assigned case load through:</p></li><li><p>
Transportation as required by treatment plan.</p></li></ul><ul><li><p>
Development of Natural Supports including family, friends, religious organizations/leaders, neighbors, teachers, employers, and all others involved and interested in supporting the consumer.</p></li><li><p>
Internal and external case collaboration and coordination, including gathering and exchanging relevant information.</p></li><li><p>
Consultant to individuals and their support systems.</p></li><li><p>
Documentation of services and supports in accordance with funding, regulatory, accreditation and best practice standards.</p></li><li><p>
Monitoring support providers in the provision of services and implementation of person-centered plans.</p></li></ul><ul><li><p>
Participation in clinical case conferences, staff development (in-services, conferences, professional organizations) and agency committees as assigned.</p></li><li><p>
Support individuals on assigned caseload through advocacy, monitoring, referring, and linking with other providers.</p></li><li><p>
Perform other duties as assigned.</p></li></ul><p><b>
EQUIPMENT/TECHNOLOGY KNOWLEDGE:</b></p><ul><li><p>
Basic iPhone Knowledge</p></li><li><p>
Office 365 Skills</p></li></ul><p><b>
POSITIONS TO BE FILLED:</b></p><ul><li><p>
One full time positions (40 hours/week)</p></li></ul><p></p><p>
</p><p>koPUJV9yU4</p></div>

Adult Case Manager

SE WA Aging & Long Term Care

<p>***<b>TO APPLY submit an online ALTC employment application on our website at: https://www.altcwashington.com/job-opportunities/</b></p><p><i>Applicants </i><i><b>MUST </b></i><i>submit an ALTC Employment Application to be considered for an interview.</i></p><p><b>CLOSES: </b>Thursday, April 30th, 2026 at 12:00pm</p><p><b>SALARY: </b>$61,980.00 to $86,530.11 annual (14-step pay plan)</p><p><b>BENEFITS:</b></p><ul><li>Health, Dental, Vision Insurance premiums through WA State Public Employee Benefits Board (PEBB), with multiple plan options available (100% Employer paid Individual premium)</li><li>PERS 2 &amp; 3 WA State Public Employee Retirement Plan and Voluntary Deferred Compensation Plan (DCP)</li><li>Employer paid Life Insurance with voluntary buy-up options</li><li>Employer contribution to Health Reimbursement Arrangement - Voluntary Employees Beneficiary Association Plan (HRA-VEBA)</li><li>Employee Assistance Program (EAP)</li><li>Progressive Paid Time Off and Sick Leave plan</li><li>12 Paid Holidays</li><li>Flexible Schedule (after probationary period)</li></ul><p><b>SUMMARY:</b></p><p>Case Manager assists adults with disabilities, older persons and family caregivers to assess their needs, screen for and assist persons to access and arrange needed in-home and community services or authorize and maintain in-home and community based services to: (1) maintain their independence in the community; (2) be diverted from nursing home or other institutional settings (3) make a timely return home following a short hospital or residential stay; and (4) remain at home with support despite functional impairments.</p><p>Develops and administers a service plan which will result in maintaining the client at the highest level of independent living possible while still addressing the issues which arise in acute situations.</p><p><b>MINIMUM QUALIFICATIONS:</b></p><ul><li><b>Bachelor's degree</b> in Social Work, Social Science, Gerontology, Psychology, Counseling, or related fields</li><li><b>Two years </b>of direct service case management or social service program experience preferred. (Experience may be paid or volunteer experience within a social service agency.)</li><li>Possession of a valid driver&rsquo;s license and minimum state-required vehicle insurance and have use of reliable transportation.</li><li>Successful completion of criminal background check</li></ul><p><b>ESSENTIAL FUNCTIONS:</b></p><ul><li>Provides information by phone, email, mail, or in person, in the office or through outreach activities to older persons, adults with disabilities, and their family caregivers regarding evaluation of and solutions to problems, service needs, and resources available in the community.</li><li>Utilizes computerized database to provide information, assistance, and referral services and to document application, eligibility and authorization.</li><li>Screens applicants for appropriate type of service and eligibility information and makes referrals as necessary.</li><li>Perform comprehensive functional assessments and reassessments for clients.</li><li>Development of an appropriate plan of care to assist client with identified outcome objectives.</li><li>Short-term and long-term intensive service plan implementation, including payment for some program services.</li><li>Resolution of client directed concerns with service delivery quality.</li><li>Coordination with providers of client services.</li><li>Termination planning and follow-up.</li><li>Utilize in-house nursing staff for case consultation, service plan development and provider oversight.</li><li>Maintenance of manual and computerized client records.</li><li>Coordination of services with other community service providers including mental health and disability service organizations.</li><li>Gives community education presentations and staffs information fairs.</li></ul><p><b>Knowledge, Skills, and Abilities:</b></p><ul><li>Knowledge of local in-home and community options and resources for the elderly and adults with disabilities and their caregivers.</li><li>Direct functional assessment, service planning and implementation experience.</li><li>Ability to research and propose solutions to a variety of problems presented by clients.</li><li>Ability to function in a multi-lingual, multi-cultural environment, including providing service with use of interpreters.</li><li>Ability to travel to and from client&rsquo;s homes and other community agencies which might not be ADA accessible.</li><li>Ability to maintain paper and electronic records and files of clients and services provided and to report those accordingly.</li><li>Work effectively with colleagues and other customers by practicing punctuality, respect for deadlines, collaborative problem solving and honest communication.</li><li>Ability to work effectively as a team member with a wide range of diverse staff and community members and to establish and maintain effective working relationships.</li><li>Ability to work independently in the field.</li><li>Ability to work under pressure, within short timelines to implement service plan.</li><li>Ability to communicate verbally in the English language in face-to-face one-on-one settings, in group settings, by personal computer, or using a telephone.</li><li>Ability to produce written documents with clearly organized thoughts using proper English sentence construction, punctuation, and grammar.</li><li>Display empathy and positive regard for others in written, verbal and non-verbal communications.</li><li>Computer and software skills including Word, Excel and database systems; ability to operate general office equipment; work at a desk using phone and computer for up to a full day&rsquo;s work schedule.</li><li>Experience using motivational interviewing or other empowerment-based approaches is desired.</li><li>Bilingual Spanish preferred</li></ul><p><b>Working Conditions and Physical Effort:</b></p><ul><li>While performing assessments in varied residential environments, the employee travels by automobile and is exposed to changing weather conditions.</li><li>A portion of the work is in a typical interior/office work environment.</li><li>While performing the duties of this position, the employee is regularly required to talk, hear, stand, walk, sit, stoop, use hand to finger, handle or feel objects, tools, or controls, grasping and reach with hands or arms.</li><li>The employee occasionally lifts or moves up to 25 pounds and/or a negligible amount of force frequently or constantly to lift, carry push, pull or otherwise move objects.</li><li>Specific vision abilities required by this job include close vision and the ability to adjust focus.</li><li>Repetitive motions to operate computer equipment while typing on keyboard and viewing computer screen.</li><li>Duties are performed in an office setting and include daily home visits to clients and their families where conditions of the home environment may not be always be ideal or predicted.</li><li>Some homes are potentially hazardous, to include unrestrained animals, inadequate housing situations, clients or family members with hostile behaviors.</li><li>Driving conditions may be in rural settings and case managers may have home visits scheduled during inclement weather.</li><li>Requires being to work in a timely fashion, able to respond to public with good customer service skills, ability to exercise good judgment as it relates to client care, following rules and regulations.</li><li>Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</li></ul><p><i><b>Southeast Washington Aging &amp; Long Term Care is an equal employment opportunity employer.</b></i></p><p><i>SE WA ALTC ensures equal employment opportunities regardless of a person&rsquo;s sex, race, national origin, religion, age, disability, marital status, creed, political belief, sexual orientation, veteran&rsquo;s status or any other protected status under federal or state statute. Disabled applicants may request accommodation to participate in the job application and/or selection process for employment. In compliance with the Immigration Reform and Control Act of 198, SE WA ALTC will only hire United States citizens and aliens lawfully authorized to work in the United States.</i></p><p>Job Type: Full-time</p><p>Pay: $61,980.00 - $86,530.11 per year</p><p>Benefits:</p><ul><li>401(k)</li><li>Dental insurance</li><li>Employee assistance program</li><li>Flexible schedule</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Retirement plan</li><li>Vision insurance</li></ul><p>People with a criminal record are encouraged to apply</p><p>Application Question(s):</p><ul><li>Our Case Manager positions require a bachelor's degree in a qualifying Social Services field, such as Psychology, Social Work, Human Services, Social Services, Counseling, Gerontology, etc.  Do you have a bachelor's degree in a qualifying field of study?</li></ul><p>Education:</p><ul><li>Bachelor's (Required)</li></ul><p>Experience:</p><ul><li>Social Work in a clinical setting: 2 years (Required)</li></ul><p>Language:</p><ul><li>Spanish (Preferred)</li></ul><p>License/Certification:</p><ul><li>Driver's License (Required)</li></ul><p>Ability to Commute:</p><ul><li>Grandview, WA 98930 (Required)</li></ul><p>Ability to Relocate:</p><ul><li>Grandview, WA 98930: Relocate before starting work (Required)</li></ul><p>Work Location: In person</p>

Case Manager

HUF Center

<div><h3 class="jobSectionHeader"><b>About the Role</b></h3><p>
The H.U.F. Center is seeking a compassionate and reliable Case Manager to support adults with mental health and co-occurring disorders in a psychosocial day support setting.<br>
As a Case Manager with Hope, Unity, and Freedom (H.U.F.) Center, you play a vital role in supporting adults with primary mental health diagnoses, co-occurring disorders, and/or substance use challenges. This position focuses on providing psychosocial day support services that promote independence, stability, and overall well-being.<br>
This is a hands-on, highly interactive role where you&rsquo;ll work closely with members throughout the day&mdash;providing direct support, facilitating interventions, and ensuring all services are clearly and accurately documented. The role requires consistency, strong interpersonal skills, and the ability to work with a diverse and sometimes high-acuity population.</p><h3 class="jobSectionHeader"><b><br>
Key Responsibilities</b></h3><ul><li>
Provide direct support and case management services to assigned members</li><li>
Observe, engage, and interact with members daily</li><li>
Complete timely documentation within 24 hours (daily notes, monthly/quarterly reports, ISPs)</li><li>
Facilitate group and individual psychosocial interventions as needed</li><li>
Assist with daily program operations (meals, breaks, general support)</li><li>
Collaborate with team members, caregivers, and external providers</li><li>
Support members with ADLs/IADLs as appropriate</li><li>
Maintain a safe, structured, and supportive environment</li></ul><h3 class="jobSectionHeader"><b>
What to Expect</b></h3><ul><li>
A fast-paced, team-oriented environment</li><li>
Daily, consistent interaction with members</li><li>
Working with individuals with mental health and co-occurring disorders</li><li>
Occasional challenging behaviors requiring professionalism and strong boundaries</li><li>
Some Saturday shifts required</li></ul><h3 class="jobSectionHeader"><b>
Qualifications</b></h3><ul><li>
Must have Virginia QMHP</li><li>
Bachelor&rsquo;s degree in Human Services, Social Work, Psychology, or related field preferred</li><li>
Experience in mental health, behavioral health, or substance use preferred</li><li>
Strong communication and organizational skills</li><li>
Ability to complete documentation accurately and on time</li><li>
Valid driver&rsquo;s license preferred</li></ul><h3 class="jobSectionHeader"><b>
Benefits &amp; Perks</b></h3><ul><li>
Health, Vision, and Dental Insurance</li><li>
Life Insurance</li><li>
Paid Time Off (PTO)</li><li>
401(k) Retirement Plan</li><li>
Pet Insurance</li><li>
Training Reimbursement &amp; Professional Development</li><li>
And more!</li></ul></div>

Mental Health Case Manager | Make a Daily Impact

<div>Description:
<h3 class="jobSectionHeader"><b>About the Role</b></h3><p>
The H.U.F. Center is seeking a compassionate and reliable Case Manager to support adults with mental health and co-occurring disorders in a psychosocial day support setting.<br>
As a Case Manager with Hope, Unity, and Freedom (H.U.F.) Center, you play a vital role in supporting adults with primary mental health diagnoses, co-occurring disorders, and/or substance use challenges. This position focuses on providing psychosocial day support services that promote independence, stability, and overall well-being.<br>
This is a hands-on, highly interactive role where you&rsquo;ll work closely with members throughout the day&mdash;providing direct support, facilitating interventions, and ensuring all services are clearly and accurately documented. The role requires consistency, strong interpersonal skills, and the ability to work with a diverse and sometimes high-acuity population.</p><h3 class="jobSectionHeader"><b><br>
Key Responsibilities</b></h3><ul><li>
Provide direct support and case management services to assigned members</li><li>
Observe, engage, and interact with members daily</li><li>
Complete timely documentation within 24 hours (daily notes, monthly/quarterly reports, ISPs)</li><li>
Facilitate group and individual psychosocial interventions as needed</li><li>
Assist with daily program operations (meals, breaks, general support)</li><li>
Collaborate with team members, caregivers, and external providers</li><li>
Support members with ADLs/IADLs as appropriate</li><li>
Maintain a safe, structured, and supportive environment</li></ul><h3 class="jobSectionHeader"><b>
What to Expect</b></h3><ul><li>
A fast-paced, team-oriented environment</li><li>
Daily, consistent interaction with members</li><li>
Working with individuals with mental health and co-occurring disorders</li><li>
Occasional challenging behaviors requiring professionalism and strong boundaries</li><li>
Some Saturday shifts required</li></ul><h3 class="jobSectionHeader"><b>
Qualifications</b></h3><ul><li>
Must have Virginia QMHP</li><li>
Bachelor&rsquo;s degree in Human Services, Social Work, Psychology, or related field preferred</li><li>
Experience in mental health, behavioral health, or substance use preferred</li><li>
Strong communication and organizational skills</li><li>
Ability to complete documentation accurately and on time</li><li>
Valid driver&rsquo;s license preferred</li></ul><h3 class="jobSectionHeader"><b>
Benefits &amp; Perks</b></h3><ul><li>
Health, Vision, and Dental Insurance</li><li>
Life Insurance</li><li>
Paid Time Off (PTO)</li><li>
401(k) Retirement Plan</li><li>
Pet Insurance</li><li>
Training Reimbursement &amp; Professional Development</li><li>
And more!</li></ul>
Requirements:</div>

Sedgwick

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Disability Representative Sr
<p></p><p><b>PRIMARY PURPOSE </b>: Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors.
</p><p></p><p><b>ESSENTIAL FUNCTIONS and RESPONSIBILITIES
</b></p><ul><li>Makes independent claim determinations, based on the information received, to approve complex disability claims or makes a recommendation to team lead to deny claims based on the disability plan.
</li><li>Reviews and analyzes complex medical information (i.e. attending physician statements, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan.
</li><li>Oversees additional facets of complex claims including but not limited to comorbidities, concurrent plans, complex ADA accommodations, and claims outside of typical guidelines.
</li><li>Utilizes the appropriate clinical resources in case assessment (i.e. duration guidelines, in-house clinicians), as needed.
</li><li>Determines benefits due pursuant to a disability plan, makes timely claims payments/approvals and adjustments for workers compensation, Social Security Disability Income (SSDI), and other disability offsets.
</li><li>Informs claimants of documentation required to process claims, required time frames, payment information and claims status by phone, written correspondence and/or claims system.
</li><li>Communicates with the claimants&rsquo; providers to set expectations regarding return to work.
</li><li>Medically manages complex disability claims ensuring compliance with duration control guidelines and plan provisions.
</li><li>Communicates clearly and timely with claimant and client on all aspects of claims process by phone, written correspondence and/or claims system.
</li><li>Coordinates investigative efforts ensuring appropriateness; provides thorough review of contested claims.
</li><li>Evaluates and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities.
</li><li>Negotiates return to work with or without job accommodations via the claimant&rsquo;s physician and employer.
</li><li>Refers cases to team lead and clinical case management for additional review when appropriate.
</li><li>Maintains professional client relationships and provides excellent customer service.
</li><li>Meets the organization&rsquo;s quality program(s) minimum requirements.
</li></ul><p></p><p><b>ADDITIONAL FUNCTIONS and RESPONSIBILITIES
</b></p><ul><li>Performs other duties as assigned.
</li></ul><p></p><p><b>QUALIFICATIONS
</b></p><p></p><p><b>Education &amp; Licensing
</b><br>
High School diploma or GED required. Bachelor's degree from an accredited university or college preferred. State certification or licensing in statutory leaves is preferred or may be required based on state regulations.
</p><p></p><p><b>Experience
</b><br>
Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred.
</p><p></p><p><b>Skills &amp; Knowledge
</b></p><ul><li>Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
</li><li>Knowledge of state and federal FMLA regulations
</li><li>Working knowledge of medical terminology and duration management
</li><li>Excellent oral and written communication, including presentation skills
</li><li>Proficient computer skills including working knowledge of Microsoft Office
</li><li>Analytical, interpretive, and critical thinking skills
</li><li>Ability to manage ambiguity
</li><li>Strong organizational and multitasking skills
</li><li>Ability to work in a team environment
</li><li>Ability to meet or exceed performance competencies as required by program
</li><li>Effective decision-making and negotiation skills
</li><li>Ability to exercise judgement autonomously within established procedures
</li></ul><p></p><p><b>WORK ENVIRONMENT
</b><br>
When applicable and appropriate, consideration will be given to reasonable accommodations.
</p><p></p><p><b>Mental </b><b>: </b>Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
</p><p></p><p><b>Physical </b><b>: </b>Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required.
</p><p></p><p><b>Auditory/Visual </b><b>: </b>Hearing, vision and talking
</p><p></p><p>The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.
</p><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</b></h2></div>

Disability Representative Sr

<div><p>By joining Sedgwick, you'll be part of something truly meaningful. It&rsquo;s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there&rsquo;s no limit to what you can achieve.
</p><p></p><p>Newsweek Recognizes Sedgwick as America&rsquo;s Greatest Workplaces National Top Companies
</p><p>Certified as a Great Place to Work&reg;
</p><p>Fortune Best Workplaces in Financial Services &amp; Insurance
</p><p></p>Disability Representative Sr
<p></p><p><b>PRIMARY PURPOSE </b>: Provides disability case management and complex claim determinations based on medical documentation and the applicable disability plan interpretation including determining benefits due and making timely payments/approvals and adjustments, medically managing disability claims including comorbidities, concurrent plans, and complex ADA accommodations; coordinates investigative efforts, thoroughly reviews contested claims, negotiates return to work with or without job accommodations, and evaluates and arranges appropriate referral of claims to outside vendors.
</p><p></p><p><b>ESSENTIAL FUNCTIONS and RESPONSIBILITIES
</b></p><ul><li>Makes independent claim determinations, based on the information received, to approve complex disability claims or makes a recommendation to the team lead to deny claims based on the disability plan.
</li><li>Reviews and analyzes complex medical information (i.e., attending physician statements, office notes, operative reports, etc.) to determine if the claimant is disabled as defined by the disability plan.
</li><li>Oversees additional facets of complex claims, including but not limited to comorbidities, concurrent plans, complex ADA accommodations, and claims outside of typical guidelines.
</li><li>Utilizes the appropriate clinical resources in case assessment (i.e., duration guidelines, in-house clinicians), as needed.
</li><li>Determines benefits due pursuant to a disability plan, makes timely claims payments/approvals and adjustments for workers' compensation, Social Security Disability Income (SSDI), and other disability offsets.
</li><li>Informs claimants of documentation required to process claims, required time frames, payment information, and claims status by phone, written correspondence, and/or claims system.
</li><li>Communicates with the claimants&rsquo; providers to set expectations regarding return to work.
</li><li>Medically manages complex disability claims, ensuring compliance with duration control guidelines and plan provisions.
</li><li>Communicates clearly and timely with claimant and client on all aspects of claims process by phone, written correspondence, and/or claims system.
</li><li>Coordinates investigative efforts, ensuring appropriateness; provides thorough review of contested claims.
</li><li>Evaluates and arranges appropriate referral of claims to outside vendors or physician advisor reviews, surveillance, independent medical evaluation, functional capability evaluation, and/or related disability activities.
</li><li>Negotiates return to work with or without job accommodations via the claimant&rsquo;s physician and employer.
</li><li>Refers cases to the team lead and clinical case management for additional review when appropriate.
</li><li>Maintains professional client relationships and provides excellent customer service.
</li><li>Meets the organization&rsquo;s quality program(s) minimum requirements.
</li></ul><p></p><p><b>ADDITIONAL FUNCTIONS and RESPONSIBILITIES
</b></p><ul><li>Performs other duties as assigned.
</li></ul><p></p><p><b>QUALIFICATIONS
</b></p><p></p><p><b>Education &amp; Licensing
</b><br>
High School diploma or GED required. Bachelor's degree from an accredited university or college preferred. State certification or licensing in statutory leaves is preferred or may be required based on state regulations.
</p><p></p><p><b>Experience
</b><br>
Three (3) years of benefits or disability case/claims management experience or equivalent combination of education and experience preferred.
</p><p></p><p><b>Skills &amp; Knowledge
</b></p><ul><li>Knowledge of ERISA regulations, required offsets and deductions, disability duration and medical management practices and Social Security application procedures
</li><li>Knowledge of state and federal FMLA regulations
</li><li>Working knowledge of medical terminology and duration management
</li><li>Excellent oral and written communication, including presentation skills
</li><li>Proficient computer skills including working knowledge of Microsoft Office
</li><li>Analytical, interpretive, and critical thinking skills
</li><li>Ability to manage ambiguity
</li><li>Strong organizational and multitasking skills
</li><li>Ability to work in a team environment
</li><li>Ability to meet or exceed performance competencies as required by program
</li><li>Effective decision-making and negotiation skills
</li><li>Ability to exercise judgement autonomously within established procedures
</li></ul><p></p><p><b>WORK ENVIRONMENT
</b><br>
When applicable and appropriate, consideration will be given to reasonable accommodations.
</p><p></p><p><b>Mental </b><b>: </b>Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
</p><p></p><p><b>Physical </b><b>: </b>Ability to sit at a desk for extended periods while operating a computer and phone system. Travel as required.
</p><p></p><p><b>Auditory/Visual </b><b>: </b>Hearing, vision and talking
</p><p></p><p>The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to or change the duties of the position at any time.
</p><p></p><p>As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors, including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $ 19.74 - $26.00 USD hourly . A comprehensive benefits package is offered, including but not limited to medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
</p><p></p><p>Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.
</p><p></p><h2 class="jobSectionHeader"><b>If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.</b></h2></div>

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