Leave and Workers' Compensation Manager

Job Summary: Under the direction of the Senior Director of Human Resources (SDHR), the Leave and Workers' Compensation Manager (LWCM) of Omni Family Health (Omni) provides professional administration and oversight to a growing network of state-of-the-art health centers serving California's Central Valley. As a member of the organization's Human Resources (HR) Department, the LWCM manages and participates in the day-to-day administration of Omni's leave of absence, workers' compensation, disability, accommodation, and return-to-work- programs. The position oversees program operations, manages complex leave and workers' compensation cases, and provides leadership and direction to assigned staff. The LWCM ensures compliance with applicable laws and regulations, administers related policies and procedures, and promotes an effective and employee-centered leave management program. Additionally, the position contributes to departmental planning, process improvements, and operational initiatives that support organizational objectives.

Job Duties:

• Participates in the day-to-day administration of Omni's leave of absence, workers' compensation, disability, accommodation, and return-to-work programs while managing overall program operations. Oversees complex case management activities and ensures compliance with applicable federal and state laws, regulations, and organizational policies.
• Provides leadership, direction, and operational oversight to assigned staff, including coaching, training, performance management, workforce planning, employee development, scheduling, and recruitment activities to ensure effective service delivery and achievement of departmental goals.
• Serves as the primary escalation point for complex leave, workers' compensation, disability, accommodation, and return-to-work matters, providing guidance, risk assessment, and recommendations to leaders, employees, and HR management.
• Develops, implements, and monitors departmental procedures, workflows, service standards, and best practices to promote operational efficiency, regulatory compliance, consistency, and a positive employee experience.
• Plans, assigns, and evaluates departmental workload and resources to ensure timely and accurate administration of leave requests, workers' compensation claims, disability claims, and accommodation requests.
• Conducts audits, case reviews, and quality assurance activities to evaluate program effectiveness, identify risks, ensure documentation accuracy, and maintain compliance with federal, state, and organizational requirements.
• Partners with HR leadership in the development, implementation, interpretation, and administration of policies, procedures, and programs related to leave administration, workers' compensation, disability management, accommodations, and return-to-work processes.
• Analyzes trends, performance metrics, claim activity, leave utilization, accommodation requests, and departmental outcomes to identify opportunities for process improvement, risk mitigation, cost containment, and enhanced service delivery.
• Collaborates with HR leadership to establish departmental goals, strategic priorities, staffing plans, budgets, operational objectives, and continuous improvement initiatives.
• Develops and delivers training, guidance, and educational resources for managers, supervisors, and employees regarding leave administration, workers' compensation, accommodations, disability programs, and return-to-work requirements.
• Partners with insurance carriers, third-party administrators, legal counsel, medical providers, regulatory agencies, and other stakeholders to resolve issues, support compliance efforts, and ensure effective program administration.
• Prepares and presents reports, analyses, recommendations, and updates regarding program performance, compliance activities, workforce trends, and operational outcomes to HR leadership and other stakeholders.
• Prepares and presents operational reports, trends, and department performance metrics to HR leadership and other stakeholders as requested.
• Ensures the department provides cohesive support to the mission, vision, and core values while delivering superior customer service.
• Works closely with all corporate branches, divisions, and/or departments in accordance with Omni's policies and procedures.
• Other duties and/or responsibilities as the LWCM may be assigned from time to time.
• Some travel may be required.

Additional Duties:

• Health Insurance Portability and Accountability Act (HIPAA) Compliance: Responsible for maintaining abreast of and in compliance with all HIPAA regulations and requirements.
• Compliance: Ensures compliance with all local, state, and federal regulations.
• Quality Assurance/Quality Improvement (QA/QI): Participates as required in QA/QI activities and contributes towards the overall quality improvement initiatives of the organization.
• Information Technology (IT): May be required to learn and use the electronic health record and its components as required by the job functions and highlighted in the policies and procedures. These components include NextGen, Practice Management System (PMS), Quality Systems Inc. (QSI), and other electronic features as they are developed and implemented, as applicable to work environment.
• Patient Centered Medical Home (PCMH): All employees will participate in PCMH at Omni Family Health.
• Audits: Contributes to required Health Resources and Services Administration (HRSA), Operational Site Visit (OSV), The Joint Commission (JC), and other audit events.

Qualifications, Education, and Experience:

• Bachelor's Degree in Human Resources, Risk Management, Business Administration, or a related field
• Professional in Human Resources (PHR), Society for Human Resource Management Certified Professional (SHRM-CP), Certified Leave Management Specialist (CLMS), Workers' Compensation Claims Administration Certification (WCCA), or a similar certification preferred.
• Six (6) years of progressively responsible Human Resources experience administering employee leave of absence, workers' compensation, disability, and accommodation programs, with three (3) years in a management role, preferably within a Federally Qualified Health Center (FQHC), healthcare, or nonprofit setting.
• Working knowledge of federal, state, and local employment laws, including the Family and Medical Leave Act (FMLA), California Family Rights Act (CFRA), Americans with Disabilities Act (ADA), California Pregnancy Disability Leave (PDL), workers' compensation laws, and related regulations.
• Experience utilizing Human Resources Information Systems (HRIS), leave management, and claims administration systems, including ADP and related applications.
• Proficient in Microsoft Office Suite (Word, Outlook, Excel, PowerPoint, etc.).
• Bilingual in English and Spanish preferred.

Skills/Competencies:

• Demonstrates the ability to lead, mentor, coach, and develop staff while fostering accountability, collaboration, and continuous professional growth. Effectively delegates work, manages performance, supports succession planning, and promotes employee engagement and development.
• Maintains advanced knowledge of leave administration, workers' compensation, disability management, accommodations, and applicable federal and state employment laws. Ensures compliance through consistent interpretation and application of policies, regulations, and best practices while mitigating organizational risk.
• Effectively manages complex leave, accommodation, and workers' compensation matters by analyzing information, identifying solutions, exercising sound judgment, evaluating risk, and resolving issues in a timely, compliant, and employee-centered manner.
• Communicates complex information clearly and professionally while building collaborative relationships with employees, leaders, medical providers, insurance carriers, legal representatives, and regulatory agencies. Handles sensitive situations with discretion, empathy, professionalism, and sound judgment.
• Demonstrates the ability to oversee program operations, analyze trends and performance metrics, identify process improvement opportunities, and implement solutions that enhance efficiency, compliance, cost-effectiveness, service quality, and the overall employee experience.

Service Commitments:

• Must be alert and respect confidentiality of information of all types "general personnel, and/or patient related information."
• Promotes and believes in Omni's mission statement.
• Ability to relate to the public regardless of race, ethnicity, religion, age, sex, disability, or economic status.

Responsible To: Senior Director of Human Resources

Classification: Exempt