What You'll Do
Oversee and manage the performance of pooled workers’ compensation programs, focusing on regulatory adherence, cost control, and optimal claims resolution. You’ll monitor significant or complex claims through direct review, site visits, and reporting analysis to ensure appropriate handling.
Lead procurement efforts by managing the RFP process for third-party administrators, aligning vendor selection with client program needs. You’ll evaluate service delivery, address performance issues, and coordinate transitions when necessary to maintain continuity of care.
Develop educational tools and resources tailored to pool members and internal teams, including research summaries, presentations, and training materials. Deliver sessions that support compliance, claims best practices, and strategic goals.
Ensure compliance with federal, state, and regulatory standards across all aspects of program operations. Conduct audits of contract adherence, technical execution, and reporting accuracy. Monitor legislative updates and advise stakeholders on potential impacts to their programs.
Manage excess claims processes, including reserve accuracy, payment tracking, settlements, and reporting. Represent the program at client board meetings, industry events, and association forums.
Requirements
- 7–9 years of relevant experience in workers’ compensation or claims management
- Bachelor’s degree from an accredited institution (preferred)
- Relevant professional certification (preferred)
- Proficiency with Microsoft Office applications
Benefits
- Flexible work schedule
- Comprehensive benefits package including medical, dental, vision, and day-one 401(k) enrollment
- Disability and life insurance
- Flexible Spending Account (FSA) or Health Savings Account (HSA)
- Generous paid time off (PTO)
- Employee Assistance Program
- Referral incentives
- Career development and internal growth opportunities
- Additional voluntary benefits available
