WC Regional Manager, Claims; Remote - Residency in Western States

Provides leadership for a regional workers' compensation claims organization in accordance with claims adjudication and benefit allocation. Responsible for the overall performance of claims operations, including claim quality, customer experience, workforce development, financial stewardship, regulatory compliance, and operational effectiveness. Leads claim professionals, and support staff in achieving organizational goals while promoting a culture of accountability, continuous improvement, collaboration, and service excellence.

JOB DESCRIPTION
Provides leadership for a regional workers' compensation claims organization in accordance with claims adjudication and benefit allocation. Responsible for the overall performance of claims operations, including claim quality, customer experience, workforce development, financial stewardship, regulatory compliance, and operational effectiveness. Leads claim professionals, and support staff in achieving organizational goals while promoting a culture of accountability, continuous improvement, collaboration, and service excellence.

include the following. Other duties may be assigned.

• Manages monoline workers' compensation unit of claim professionals and support staff.
• Leads claim team in support of department initiatives and strategies in cost containment, case file handling, customer service and quality.
• Consistently monitors workflows to maximize accuracy and efficiency. Maintains an acceptable level of service and customer satisfaction and retention.
• Effectively manages the quality review process.
• Develops unit goals, objectives, processes, procedures and systems.
• Stays abreast of changes in workers’ compensation statutes, case law and rehabilitation advancements.
• Identifies team staffing needs and takes necessary measures to ensure appropriate levels of service.
• Mentors employees and develops career paths with growth opportunities.
• Participates in development of annual departmental budget, monitors budget and identifies budget discrepancies. Researches cause of discrepancies and makes recommendations.
• Participates in special projects and serves on committees as needed.

Relevant combination of education and experience may be considered in lieu of degree.

• Bachelor’s degree in a related field.
• Seven (7) years of experience in a claim environment with demonstrated technical experience that provides the necessary knowledge, skills and abilities.
• Three (3) years of supervisory or leadership experience in claims required.
• Previous workers’ compensation claim management with multi-jurisdictional experience preferred.
• Bilingual skills preferred.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Knowledge of team building and employee motivation theories with the ability to effectively manage multi-functional employee teams.
• Demonstrated leadership abilities.
• Knowledge of laws, regulations and compliance requirements related to workers’ compensation insurance.
• Demonstrated technical knowledge of insurance administration, claims management or relevant insurance expertise.
• Ability to work with and empower others on a collaborative basis to ensure success of unit team.
• Excellent oral and written communication skills.
• Knowledge of insurance and underwriting techniques, agency and policyholder needs.
• Ability to effectively present budgetary and/or cost information and respond to questions as…