Workers Compensation Program Manager (Administrator I) - Risk Management

at  California State University San Bernardino

MINIMUM QUALIFICATIONS: REQUIRED EDUCATION AND EXPERIENCE

• Bachelor’s degree in Business Administration, Public Administration, Human Resource Management or related field from an accredited college or university and two to five (2-5) years of professional and supervisory experience.

REQUIRED QUALIFICATIONS

• Three (3) years experience in benefits administration with an emphasis in workers’ compensation claims handling, claims supervision, brokerage of claims services and/or risk management
• Two (2) years experience developing, analyzing, and preparing workers’ compensation statistical claims data
• Skills, knowledge, and abilities required for this position. As listed in Classification Standards.
• Skill effectively managing multiple projects, priorities and deadlines; problem solving; using PC computer systems and software including Microsoft Office suite, Peoplesoft, and claims management database software.
• Knowledge in workers’ compensation strategic planning and development of workers’ compensation claims analysis methods. Functional knowledge of California workers’ compensation law. Knowledge of principles of risk management and methodologies for risk transfer, control and financing as related to workers’ compensation and return to work programs.
• Ability to establish and maintain department priorities, processes and procedures; exercise sound judgement; administer innovative plans, programs and services; communicate effectively in oral and written form; establish and maintain effective relationships; work independently and work cooperatively with a diverse campus community.

PREFERRED QUALIFICATIONS

• Professional designations such as Certified Workers’ Compensation Professional (CWCP), and/or Workers’ Compensation Claims Professional (WCCP) or Worker’s Compensation Claims Administration (WCCA) certification, and/or Associate In Claims (AIC), and/or Associate in Risk Management (ARM) preferred.

Workers’ Compensation Program Administration

• Manages the daily operations of the CSUSB workers’ compensation program in accordance with the self-insurance CSURMA program. Oversees third-party administrator files; assists with legal settlement strategies and processes. Maintains files, records, and other documents. Handles claims from inception to resolution. Responds to workers’ compensation claims requests from third-party partners and attorneys. Reviews, monitors and provides recommendations and strategies to mitigate claims exposure and settle claims.
• Claims management includes: claims processing and research, medical case management, discovery coordination, legal case management, return to work programs, and loss reporting. Monitors claims activity and provides effective feedback to third party claims administrator to optimize workers’ compensation program results.
• Maintains compliance with applicable laws and regulations, and technical guidance issued by the CSU Chancellor’s Office.
• Develops and implements training and regular communications for campus employees, supervisors, department heads, and deans concerning the University’s Workers’ Compensation Program

Program Management & Reporting

• Provides guidance and advice on the development of claims services, functions, policies, programs and regulatory matters as they relate to Workers’ Compensation. Gathers, analyzes, and reports complex workers’ compensation data. Prepares statistical workers’ compensation data and trending analysis. Creates and maintains databases for claims management and reporting as appropriate. Implements proactive solutions to current loss trends. Ensures workers’ compensation claims are managed in compliance with regulatory requirements and guidelines. Informs management of large loss cases and performance of occupational health providers. Responsible for all system-wide reporting on workers’ compensation program experience and trends for the campus. Develops and maintains regulatory reporting and documentation relating to occupational injuries and illnesses. Represents the University at depositions and hearings as appropriate. Provides recommendations and implement strategies to reduce costs associated with the Workers’ Compensation program.
• Monitors and interprets laws and policies regarding industrial injuries, illnesses, and disability. Recommends appropriate and timely changes to ensure compliance and optimize workers’ compensation program performance.

Loss Control Program Administration

• Coordinate with the Office of General Counsel, campus administrators and Human Resources to ensure information requests meet applicable policies, procedures and regulations. Assist in claim defense preparation of litigated cases including litigation holds, coordination of documents, scheduling, attorney liaison, and case preparation. Collect, file, and evaluate information to assess the University’s position relative to subpoenas. Release records in compliance with applicable laws and regulations including FERPA and HIPAA.
• Develop, implement, manage and improve program initiatives as assigned in coordination with CSUSB departments and off campus entities. Monitor the performance of the programs and recommend appropriate and timely change in services, and procedures to optimize Risk Management program performance.

Collaboration

• Establishes and maintains critical relationships with key stakeholders in a diverse campus community including but not limited to, the Workers’ Compensation Third Party Administrator, Office of General Counsel and outside attorneys, Medical Providers, Systemwide Office of Risk Management, Human Resources, Deans, Department heads and senior University leadership. Participates in committees, panels, and peer association activities. Collaborates with the Office of Environmental Health and Safety on research and projects to reduce claims. Participates in personal and professional development, including legal case law updates, educational seminars, and conferences. Represents the Office of Risk Management as directed or appropriate on university committees and work groups. Leads University-wide committees and work teams as directed or appropriate.