Duties and Responsibilities:

Carry out the Administration of SJRMC Associate Benefits Plans and Programs:

• Conduct the benefits presentation at the New Caregiver Orientation (NCO) twice per month, as required by the Learning & Development Department
• Conduct benefit enrollment meetings/sessions and other informational sessions as needed to ensure that Caregivers are enrolled in benefit programs on a timely basis
• Work closely with benefits service providers to promote a good working relationship and ensure an acceptable level of customer service, including troubleshooting vendor or other system issues to ensure a seamless process for our Caregivers who utilize the vendor systems and sites (This requires high levels of critical thinking, attention to detail, creative problem solving, and proactive communication with all applicable parties.)
• Assist with resolving non-routine or complex claims issues and other benefits-related matters, including Short-Term Disability (STD), Long-Term Disability (LTD), death, retirement, medical, dental, and vision
• Respond to benefits inquiries from leadership and Caregivers with expert-level knowledge to provide timely and accurate information that satisfies requests
• Audit reports for data integrity, and specifically audit payroll reports bi-weekly for accuracy of benefits deductions
• Preview import files (benefits enrollment vendor / Lawson) and correct any errors in the system
• Terminate Caregivers in the Benefits Enrollment System each pay period (after final check distribution)
• Maintain close working relationships with vendors in providing service and education to Caregivers
• At the direction of the Total Rewards Director, review benefits policies and plan documents, summaries, booklets, forms, and other materials to ensure accuracy
• Serve as liaison for pharmacy claims and issues
• Serve as a project coordinator during the implementation of benefit related systems and for any maintenance required
• Enter data into the HRIS system (Workday) and all other benefits related systems and databases in a timely and accurate manner to meet critical deadlines while always maintaining confidentiality.
• Serve as the benefits contact person for San Juan IPA provider offices as needed to support their HR needs
• Train and guide other Caregivers at the Center for Workforce Excellence (CWE) who need to serve as a back-up or support to the Benefits Specialist role

Leave of Absence Administration for SJRMC:

• Serve as the subject matter expert and key contact for the leave of absence programs in alignment with the organization’s policies and procedures, and under the general direction and guidance of Total Rewards Director
• Interpret and administer leave programs and policies in accordance with the applicable federal and state employment laws (i.e., FMLA, ADA, USERRA, Pregnancy Discrimination Act, etc.)
• Administer all aspects of leave programs
• Provide extensive case management and coordinate administrative aspects of cases and claims
• Administer the leave program and coordinate the leave approval and/or denial based on relevant medical information
• Coordinate and organize all medical information and ensure HIPAA and Employee Privacy guidelines are closely monitored and effectively executed
• Manage all administrative aspects of leave claims to include tracking hours used/taken, and work closely with the Payroll Department to ensure Caregiver pay is accurate
• Work closely with Caregivers to ensure that all relevant completed medical documentation is submitted for timely review
• Maintain appropriate contact with all Caregivers on leave and coordinate all aspects of return to work for Caregivers on leave
• Produce and manage reporting metrics and analytics for all leave cases and claims, and present reports as requested
• Manage STD/LTD programs and vendor relationships, ensuring that STD claims are coordinated with FMLA or general medical cases
• Assist in the creation and facilitation of leave administration training programs
• File all paper and e-documents in a timely and organized manner to allow for proper tracking and verification
• Each employee is responsible for implementing SJRMC’s Service Standards into their daily work:

                                                     Safety, Courtesy, Effectiveness, and Stewardship

• Other duties as assigned

Physical Requirements and Environmental Working Conditions:

• Work in a typical office setting with heavy to moderate amount of work in front of a computer monitor
• Sit for long periods of time with moderate to light amount of walking, stooping, and bending