OHS Clinic and Claims Manager

Responsibilities

• Oversee daily operations and service delivery of the onsite occupational health clinic
• Partner with clinic providers and vendor partners to ensure effective treatment, case management, and employee care
• Maintain clinic utilization, service levels, medical surveillance programs, and operational performance metrics
• Support employee health programs, medical testing, and occupational health initiatives
• Administer and oversee injury, property, liability, environmental, workers’ compensation, and builder’s risk claims from reporting through resolution
• Manage claim files, settlement status, reserves, communication histories, and supporting documentation in accordance with internal procedures
• Monitor claim costs, reserves, and settlements and provide recommendations to leadership based on financial analysis
• Prepare loss run, benchmark, and claims trend reports
• Manage and coordinate OCIP enrollments and determine appropriate levels of coverage for new enrollees
• Manage and coordinate relationships and performance of occupational health vendors, clinic providers, TPAs, insurance carriers, and other claims-related service partners
• Conduct regular business reviews with vendors to ensure quality, cost effectiveness, and alignment with organizational objectives
• Identify claim trends, root causes, and systemic risk exposures and develop risk mitigation strategies to reduce organizational losses
• Recommend and implement improvements to claims policies, procedures, and reporting processes
• Evaluate the performance of TPAs and external vendors and implement corrective actions when necessary
• Evaluate the performance of TPAs and external vendors and implement corrective actions when necessary
• Support organizational objectives through loss analysis, cost containment initiatives, and continuous improvement efforts
• Lead, mentor, and provide performance input for Claims personnel while promoting continuous learning and professional development
• Train internal departments on claims reporting procedures, documentation requirements, and claims handling best practices
• Share lessons learned and claims-related knowledge to improve organizational awareness and consistency
• Partner with HR, EHS, Operations, and clinic providers to support return-to-work programs and employee case management activities
• Coordinate accommodation, work restrictions, and transitional duty discussions to facilitate safe and timely return-to-work outcomes
• Coordinate post-incident investigations with Operations, EHS, HR, and Legal to ensure thorough documentation and evidence collection
• Participate in safety committees, crisis response teams, and emergency response activities to provide claims guidance
• Serve as liaison between employees, medical providers, attorneys, insurance carriers, brokers, TPAs, and other stakeholders throughout the claims process
• Support and work closely with onsite medical clinic staff to assist injured workers and support employment-mandated medical testing
• Ensure occupational health programs and medical surveillance activities comply with applicable OSHA regulations and company requirements
• Support medical monitoring, fitness-for-duty programs, respiratory protection programs, and employment-related medical testing
• Ensure compliance with insurance reporting requirements, regulatory standards, and internal claims management procedures
• Manage litigation strategy in coordination with Legal, including pleadings, discovery responses, settlement negotiations, and related legal activities
• Attend mediations, arbitrations, depositions, and trials as required
• Recommend and assist in the selection and management of legal counsel for complex claims
• Support OSHA compliance and workplace safety initiatives through claims analysis and investigation activities
• Provide leadership, coaching, and performance management for direct reports
• Oversee clinic vendors, healthcare providers, third-party administrators, and other external service partners to ensure effective service delivery and organizational alignment

Qualifications

• Required Education, Certifications, and Licenses: Bachelor’s Degree in Risk Management, Insurance, Business Administration, Occupational Safety, Occupational Health, Nursing, Healthcare Administration, Human Resources, or related field
• Relevant experience may be substituted for required education
• Preferred Master’s Degree in Business Administration, Risk Management, Occupational Safety, Public Health, Healthcare Administration, Law (JD), or related field
• ARM - Associate in Risk Management
• AIC - Associate in Claims
• INS - Certificate in General Insurance
• CPRS - Construction Risk and Insurance Specialist
• CPCU - Chartered Property Casualty Underwriter
• OSHA 1904 Record Keeping Standard
• Essential Qualifications: 5+ years of progressive leadership experience in occupational health, workers' compensation, claims management, risk management, clinic operations, or a related field
• Experience overseeing occupational health programs, clinic operations, vendor-managed healthcare services, or employee case management programs
• Experience supporting return-to-work, transitional duty, and accommodation processes
• Experience managing external vendors, healthcare providers, TPAs, or insurance partners
• Proven experience managing general liability, workers’ compensation, builder’s risk, pollution/environmental, and property claims
• Familiarity with OSHA regulations and safety compliance in an industrial environment
• In-depth knowledge of insurance policies, claim processes, legal documentation, and TPA management
• Strong skills in loss analysis, trend identification, and risk mitigation planning
• Proficient in Microsoft Office Suite, risk management systems (e.g., RMIS), and digital claims platforms
• Effective interpersonal, negotiation, and conflict-resolution skills
• Exceptional written and verbal communication and the ability to present complex information clearly
• Demonstrated ability to manage multiple priorities, projects, and stakeholders in a high-pressure environment
• Strong judgment and analytical thinking in high stakes claim and litigation scenarios
• Must have working-level knowledge of the English language, including reading, writing, and speaking English
• Alignment to Panasonic’s seven (7) core principles (contribution to society, fairness and honesty, cooperation and team spirit, untiring effort for improvement, courtesy and humility, adaptability, gratitude)