Manage all aspects of client’s large-loss and high-profile worker’s compensation program to ensure regulatory compliance and that contractual performance standards are met by their third-party administrators (TPAs).
Provide members with a resource for workers’ compensation information that helps them better understand the complexities of the system.
Conduct large-loss and high-profile case monitoring, on-site, on-line and by report.
Research and manage the RFP process for third party administrators (TPA) services based on client needs for their Workers Compensation program.
Ensure compliance with performance standards/requirements and compliance with all state, federal and regulatory reporting requirements.
Maintain client relationships by monitoring ancillary vendors and addressing service concerns with providers.
Conduct oversight reviews for adherence to contract compliance, technical standards, and regulatory requirements.
Identify and develop training programs specifically related to oversight needs.
Manage the program for excess claims to include accurate and current reporting, reserves, compliance, payments, and settlement.
Monitor legislation and changes in state and federal laws while working with clients on impacts to their workers’ compensation programs or services provided by their TPA.
Present at client board meetings, association, or other public events.

Bachelor's degree from an accredited college or university preferred.
Seven to nine (7-9) years of related experience or equivalent combination of education and experience required.
Excellent oral and written communication skills, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiating skills
Ability to create and complete comprehensive, accurate and constructive written reports
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Workers' Compensation Claims Program Manager

Key skills