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Job Description:Leads the design, development, implementation, and monitoring of enterprise-wide program strategies, aligned policies, and supportive procedures to ensure a just and effective resolution of workers’ compensation claims resulting from the operations of the organization.
Oversees the efficiency and effectiveness of the enterprise-wide workers’ compensation program to include the self-administration program and all TPA(s) in self-insured states.
Oversees and manages the relationship with the contracted third-party administrators (TPAs) to support the workers compensation program and to provide the best quality service to injured caregivers at the lowest costs. Develops and ensures TPAs’ compliance with established performance metrics.
Assesses and continuously monitors the cost effectiveness of the workers compensation program and identifies inefficiencies and recommends/implements process improvements.
Negotiates TPA and software vendor contracts.
Oversees compliance, reporting, and claim activity regarding multi-state program and monopolistic states.
Manages and participates in the development and implementation of specific priorities, policies and procedures for the enterprise-wide workers compensation program.
In consultation with TPAs and outside legal counsel, participates in the development and execution of strategies to manage specific cases and resolve issues/concerns.
Partners with Safety and Employee Health to identify highest severity causes and highest trends in caregiver safety and work together on injury prevention. Ensure seamless processes are in place to support the injured caregiver and facilitate return to work plan during the workers’ compensation process.
Oversight and responsibility for state regulatory filings, including self-insurance submissions and maintaining effective relationships with state regulatory agencies.
Stays abreast of workers’ compensation industry best practices, trends, innovations and local and national legislation pertaining to workers compensation administration.
Oversight of the worker’s compensation claims data base.
Develops goals, objectives and work standards and conducts performance evaluations of staff.
Educates and trains caregivers across the enterprise on workers’ compensation policies and procedures, claims loss trends and industry issues.
Prepares data analytics reports to identify key cost components and underlying trends.
Recommends, implements and monitors enterprise-wide cost containment strategies to prevent and minimize losses.
Oversees and manages high severity workers compensation claims.
Collaborates with the Chief Risk Officer on workers compensation insurance placements, regulatory matters, departmental operations, and other job duties as assigned.
Minimum Requirements
Juris Doctor degree preferred, but may substitute bachelor’s degree in risk finance, business administration, risk management, insurance or a directly related field and a minimum of 10 or more years’ experience related to management/oversight of a Workers Compensation or Claims Management programs.
Ten (10) years of supervisory or management experience related to the responsibilities of the position, including supervision of claims adjusters and/or TPAs; working directly with state regulators, insurers and insurance brokers.
Comprehensive knowledge of and/or ability to: (a) analyze federal, state and local laws, regulations and guidelines regarding the administration of workers compensation claims; (b) develop and implement workers compensation claims management principles, practices and procedures; (c) interpret and understand medical and technical terminology used in workers compensation injury cases; and (d) administer department contracts and vendor relationships.
Experiencer overseeing multi-state workers compensation claims or Property & Casualty claims on a national basis.
Experience performing data analytics and claims loss trending on an organizational and national basis.
Experience conducting internal claims audits and working with auditors on external audits.
Experience providing claims training and education throughout a large organization.
Experience providing presentations to leadership and working with various stakeholders throughout an organization.
Strong organizational, communication and writing skills.
Results and detail oriented.
Demonstrated willingness to take on job challenges and departmental projects.
Strong analytical skills and ability to analyze information and use logic to address work or job issues and problems.
Ability to think outside the box and collaborate in a cross-departmental capacity
Preferred QualificationsHealthcare, insurance industry, claims management or TPA experience preferred.Physical Requirements:Interact with others by effectively communicating, both orally and in writing.- and -Operate computers and other office equipment requiring the ability to move fingers and hands.- and -See and read computer monitors and documents.- and -Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.- and -May require lifting and transporting objects and office supplies, bending, kneeling and reaching.Anticipated job posting close date:07/28/2024Location:Peaks Regional OfficeWork City:BroomfieldWork State:ColoradoScheduled Weekly Hours:40The hourly range for this position is listed below. Actual hourly rate dependent upon experience.$45.32 - $83.10We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) .Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.