Manager - Worker’s Compensation Claims (Risk Management)

About the role

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The Workers’ Compensation Claims Manager manages and provides strategic oversight of the city’s workers’ compensation claims program and return-to-work (RTW) initiatives. This position ensures workers’ compensation claims are managed efficiently, cost-effectively, and in compliance with applicable laws and regulations while supporting injured employees in achieving safe and timely recovery and returning to productive work. The Manager provides leadership to workers’ compensation coordinators and serves as a key partner to city departments, third-party administrators (TPAs), workers’ compensation medical network providers, nurse case management, and other stakeholders. The role identifies opportunities to reduce claim costs and duration, improve claim outcomes, strengthen RTW practices, and promote a consistent approach to workplace injury management.

Responsibilities

• Oversee the workers’ compensation claims program from initial injury reporting through resolution and closure.
• Provide leadership, direction, and support to claims staff and coordinators and ensure claims are managed according to established standards and applicable regulations.
• Monitor claim inventories, reserves, payments, medical treatment, indemnity exposure, litigation, and overall claim status.
• Review complex, catastrophic, litigated, and high-exposure claims and establish appropriate action plans.
• Partner with TPAs, defense counsel, medical providers, and other vendors to ensure effective claim management.
• Review and evaluate claim reserves, settlement recommendations, litigation strategies, and financial exposure.
• Monitor claim handling for compliance with applicable workers’ compensation laws, regulations, contractual requirements, and company policies.
• Identify trends in claim frequency, severity, duration, and costs and develop strategies to improve overall program performance.
• Conduct periodic claim reviews with internal stakeholders and external claims administrators.
• Ensure accurate and timely claims reporting, documentation, investigation, communication, and resolution.
• Own and provide strategic oversight of the organization’s return-to-work and transitional-duty program.
• Develop, implement, and maintain consistent RTW policies, procedures, guidelines, and best practices.
• Partner with Human Resources, Safety, Occupational Health, managers, supervisors, and medical providers to facilitate safe and timely employee returns to work.
• Establish processes for evaluating temporary work restrictions and identifying appropriate transitional-duty assignments.
• Ensure restrictions and accommodations are appropriately documented, communicated, monitored, and updated.
• Monitor employees on temporary restrictions and ensure work assignments remain consistent with current medical restrictions.
• Establ