Workers Compensation Program Specialist Senior

What You’ll Do

• Serve as an organizational expert on workers’ compensation policies, laws, practices, and regulatory requirements
• Develop and implement workers’ compensation program goals, objectives, policies, and advanced cost-containment strategies
• Provide strategic oversight of the workers’ compensation TPA, including performance reviews and audits designed to optimize claims outcomes
• Manage complex and high-stakes claims, settlements, employer-level investigations, and regulatory matters
• Lead initiatives such as the Transitional Work Program and identify opportunities to improve program effectiveness and efficiency
• Develop key performance indicators (KPIs), benchmarks, and data analytics to evaluate program performance, identify injury trends, and reduce costs
• Lead financial analyses and reporting, including cost-benefit analyses, reconciliation improvements, and return-on-investment measurements
• Prepare and present financial, claims, and program performance reports to executive leadership
• Ensure required Department of Industrial Relations reporting is completed accurately and timely
• Develop and maintain effective partnerships with legal counsel, medical providers, TPAs, and other industry partners
• Author and communicate policy and program updates to employees, leadership, and other stakeholders
• Advise employees on workers’ compensation matters and champion timely, effective support for injured employees
• Mentor and coach team members and stakeholders to strengthen workers’ compensation knowledge and promote continuous improvement
• Represent OCTA on workers’ compensation matters at meetings, audits, presentations, and external forums
• Support safety initiatives and related training activities as needed

What We’re Looking For

• Bachelor’s degree in Finance, Business Administration, or a related field, or an equivalent combination of education and experience
• Minimum of five years of workers’ compensation claims experience
• State of California Self-Insured Certificate required
• Advanced knowledge of workers’ compensation laws, claims practices, policies, and regulatory requirements
• Experience overseeing third-party claims administrators and working with legal counsel, medical providers, and other business partners
• Demonstrated ability to manage complex claims and high-stakes workers’ compensation matters
• Strong analytical skills with the ability to use claims and financial data to identify trends, evaluate performance, and recommend solutions
• Experience developing KPIs, performance measures, reports, and cost-containment strategies
• Strong problem-solving skills and a solutions-oriented approach to complex claims and program challenges
• Excellent written, verbal, presentation, and relationship-building skills
• Ability to lead initiatives, influence stakeholders, and mentor others without direct supervisory authority
• Experience with claims management technology, such as Origami, is valuable for success in this role