Home / Worker's Compensation Program Manager

Worker's Compensation Program Manager


Summary

Day shift - no holidays or weekend rotations.

Job Description

Workers Compensation Program Manager

Schedule: Monday- Friday; Days- 40 hours per week.

Location: This position is located in Lancaster, PA.

POSITION SUMMARY: The Worker’s Compensation Program Manager directs, manages, and is responsible for coordinating care for all Penn Medicine- Lancaster General Health employees that become injured while on the job, requiring services beyond first-aid, in accordance to the mission and vision of the organization. The Program Manager will oversee the Worker’s compensation staff, and ensures that all workers’ compensation injuries, reports, statements, and communication with the third party administrator are handled properly and in accordance with the federal requirements as well as the Pennsylvania Department of Labor and Industry laws. Responsible to identify and implement best practices to ensure highest quality claims outcomes, while analyzing financial impacts of injury circumstances. Professional worker’s compensation specialists demonstrate abilities to relate well to others, manage sensitive data, communicate effectively in spoken and written forms, and understand human behavior in a work environment.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

  • Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process – maintain personal contact with injured employee who is away from the workplace, and provide supervisors with information and assistance regarding injured worker’s status.
  • Maintains staff competency level by providing training for all components of reporting and management of employees with potentially work related illness or injuries.
  • Key business contact for all LGH employee worker’s compensation claims with PA State Worker’s Compensation Bureau, Penn Medicine Worker’s compensation manager, Third Party Administrator’s staff and adjusters, and any regulatory agency associated with this work.
  • Provide initial injury report and supporting documentation of investigation regarding injured employee to third party administrator adjusters, for both medical only and indemnity claims – review reports filed by employees for completion and timely submission related to the incident.
  • Ensure processing of all injury forms, wage statements and supplemental medical evaluation forms as required.
  • Track claim information and expenses and report to WCAIS (Worker’s Compensation Automated Information System) as required.
  • Maintains communication with the Director of the Department and provides updates on the status of self-insurance application and submission deadlines, reporting activities, as well as carries the responsibility for claim review completion, data submission, and management of direct reports with the worker’s compensation team.
  • Provide timely and accurate reporting of all claims as requested by external regulatory bodies and internal departments in collaboration with Penn Medicine corporate worker’s compensation team, while maintaining pristine documentation.
  • Inform injured workers of all treatment options, consistent with designated panel when appropriate within the first 90 days of injury occurring.
  • Coordinate claims case management with physicians and other health care professionals, identifying cases in need of additional medical management beyond initial injuries.
  • Evaluate injured employee’s compliance with prescribe medical and physical therapy regimens, collaborating with third party administration claims adjusters.
  • Conduct and evaluate legal strategy conference calls at regular intervals for all cases under litigation or it’s potential, with attorneys and third party adjusters.
  • Knowledgeable in an array of injury-specific medical options for individual claims cases.
  • Develop, implement, monitor and be accountable for the budget for the defined area(s) of responsibility in collaboration with direct supervisor.
  • Assess and monitor subrogation claims for resolution in collaboration with the third party adjuster.
  • Effective and timely coordination of communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
  • Advocate for a work environment that minimizes work-related illness and injury – collaborating with the Safety team to ensure identification of trends in employee injuries through timely reporting of injuries
  • Collaborate with injured employee’s direct supervisor and Human Resources to provide jobs that meet the injured employee’s designated work restrictions, while in accordance with maintaining gainful employment within the health system.
  • Provide review of worker’s compensation policies in collaboration with operational leaders.
  • Develops and supports goals that engage Worker’s compensation staff and drive quality and process improvement throughout the department, in alignment with Penn Medicine and LGH goals.

SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:

  • Collaborate with safety and educational personnel to plan and implement brief orientation for managers regarding worker’s compensation policies and procedures.
  • Participate in developing departmental policy regarding standard work for reporting and processing of injury reports and required PA state documents.
  • Other duties as assigned.

JOB  REQUIREMENTS

MINIMUM REQUIRED QUALIFICATIONS:

  • Master’s degree in Business, Human Resources or other associated fields.
  • Knowledge of workers’ compensation laws and procedures, including ability to track claim information and expenses.
  • Two to five (2-5) years’ experience successfully adjusting claims, or other relevant safety experience.
  • Excellent oral and written communication skills.
  • Exceptional analytic and negotiation skills.
  • One to two (1-2) years of direct supervision of staff, or comparable leadership requirements
  • Must obtain Worker’s Compensation Claims Professional or Administration certification within two years of employment in position.

PREFERRED  QUALIFICATIONS:

  • Experience processing worker’s compensation claims within a self-insured organization.
  • Experience processing worker’s compensation claims with a healthcare system.
  • Worker’s Compensation Claims Professional or Administration certification.

Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards. The percentages of time spent performing job duties are estimates, and should not be considered absolute. The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole. Incumbent must be able to perform all job functions safely.

#LI-MD1

Benefits At A Glance:

PENN MEDICINE LANCASTER GENERAL HEALTH offers the following benefits to employees:

  • 100% Tuition Assistance at The Pennsylvania College of Health Sciences
  • Paid Time Off and Paid Holidays
  • Shift, Weekend and On-Call Differentials
  • Health, Dental and Vision Coverage
  • Short-Term and Long-Term Disability
  • Retirement Savings Account with Company Matching
  • Child Care Subsidies
  • Onsite Gym and Fitness Classes

Disclaimer

PENN MEDICINE LANCASTER GENERAL HEALTH is an Equal Opportunity Employer, committed to hiring a diverse workforce. All openings will be filled based on qualifications without regard to race, color, sex, sexual orientation, gender identity, national origin, marital status, veteran status, disability, age, religion or any other classification protected by law.

 

Search Firm Representatives please read carefully: PENN MEDICINE LANCASTER GENERAL HEALTH is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, all resumes submitted by search firms to any employee at PENN MEDICINE LANCASTER GENERAL HEALTH via-email, the Internet or directly to hiring managers at Penn Medicine Lancaster General Health in any form without a valid written search agreement in place for that position will be deemed the sole property of PENN MEDICINE LANCASTER GENERAL HEALTH, and no fee will be paid in the event the candidate is hired by PENN MEDICINE LANCASTER GENERAL HEALTH as a result of the referral or through other means.

LGH Full Time Posted on 08/15/2022