Psychiatric Nurse Practitioner Lead-Medical Leave of Absence - Jersey City, United States - Alight

Description

Our Story

At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to Be Alight.

Our Values

Champion People - be empathetic and help create a place where everyone belongs.

Grow with purpose - Be inspired by our higher calling of improving lives.

Be Alight - act with integrity, be real and empower others.

It's why we're so driven to connect passion with purpose. Our team's expertise in human insights and cloud technology gives companies and employees around the world the ability to power confident decisions, for life.

With a comprehensive total rewards package, continuing education and training, and tremendous potential with a growing global organization, Alight is the perfect place to put your passion to work.

Join our team if you Champion People, want to Grow with Purpose through acting with integrity and if you embody the meaning of Be Alight.

Learn more at .

About the Role

Psychiatric Nurse Practitioner Lead of Medical Leave of Absence will provide oversight and direction to Clinical Case Managers managing behavioral health short-term disability and work accommodation claims. This role includes business continuity and crisis response along with collaboration with the Head Medical Leave of Absence Physician on process improvements and innovation to best serve our Client and their Medical Leave of Absence program.

Responsibilities

• Primary responsibility involves serving as the Psychiatric Advisor overseeing the occupational health and disability leave management program which includes clinical case management advisement, treating provider contacts, employee contacts, strategic development, and oversight of behavioral health claim management services.
• Assists case managers in a better understanding of the emotional, behavioral, and cognitive functioning of the employee/claimant with respect to relevant work demands. Provides initial and ongoing clinical guidance, and as applicable, reviews the treatment plan and standards of care in context of a treating providers' projected return to work dates.
• Conducts comprehensive disability claim file reviews and peer-to-peer consults to address specific questions and claim dynamics that require psychiatric expertise in clarifying a patient's functional impairment and/or projected work capacity.
• Supports operational functions via consultation with the Client, vendors, internal leadership, and case managers, and directs and coordinates psychiatric reviews and complex claim discussions related to disability, clinically reasonable accommodations, and permanent restrictions.
• Provides physician coverage for entire team when lead physician is unavailable (e.g., PTO)

Clinical Case Management Leadership

Provide clinical oversight and training to a team of nurse and behavioral health case managers via the following:

• Consulting and assisting in gathering and interpreting information related to psychiatric disability and/or leave of absence claims and claim management strategies.
• Training the case manager personnel on various behavioral health topics as needed.
• Provide on-going support in the form of consultation to the claim management team as needed and provide daily walk-in hours for case management discussion and direction.
• Conduct file reviews and peer-to-peer consults, liaising and negotiating with treating providers to address claim dynamics, and clarify and confirm medical necessity of disability, and accommodation requests.
• Negotiate with employees and Client/employer as needed to streamline return to work.
• Understand our Client's wellness resources and utilize critical thinking skills to engage all available resources to ensure optimal outcomes for all cases.
• Collaborate with our Client's Human Capital Management and Employment Law teams in managing employees' medical leave of absence and accommodations.

Strategy Development

• Collaborate on the development of clinical content and claim management strategy as needed with operations management.
• Lead case management strategy and participate in regularly scheduled complex case discussions with the team and Client.
• Review and collaborate on development and revision of standard operating procedures and protocols related to psychiatric claims.
• Independently interpret behavioral health business data and speak to opportunities and operational improvements.
• Demonstrate strong presentation skills, including designing visuals such as PowerPoint.

Requirements

• Active state or jurisdiction Nurse Practitioner licensure.
• Minimum 5 years' experience in reviewing disability claims related to psychiatric conditions.
• Maintains Applicable Certifications, e.g. The American Board of Independent Examiners, The American Academy of Disability Evaluating Physicians (AADEP)
• Demonstrates empathy and compassion in interactions with customers as well as in coaching case managers.
• Embraces customer service and communicates professionally in all written and verbal interactions.
• Champions change management.
• Leads initiatives to ensure best practices are implemented and adhered to.
• Has a strong working knowledge of medical and behavioral health disorders.
• Can quickly and seamlessly integrate into a very fast paced working environment. Independently networks and develops valuable interpersonal business relationships with all stakeholders.
• Able to convey clinical opinion clearly and efficiently to non-clinical stake holders, without hesitation.
• Receptive to feedback.

Flexible Working

So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and Top 100 Company for Remote Jobs 5 years in a row.

Benefits

We offer programs and plans for a healthy mind, body, wallet and life because it's important our benefits care for the whole person. Options include a variety of health coverage options, wellbeing and support programs, retirement, vacation and sick leave, maternity, paternity & adoption leave, continuing education and training as well as a number of voluntary benefit options.

By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight's employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.

Our Commitment to Diversity and Inclusion

Alight is committed to diversity, equity, and inclusion. We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful.

At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future.

Diversity Policy Statement

Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state or local law. In addition, we take affirmative action to employ and advance in the employment of qualified minorities, women, disabled persons, disabled veterans and other covered veterans.

Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request a reasonable accommodation/modification by contacting his/her recruiter.

Authorization to work in the Employing Country

Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the Employing Country and with Alight.

Note, this job description does not restrict management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.