Basic Qualifications:
Must have experience leading and/or training a workers' compensation team.
Core Competencies:
- Bachelor's Degree in Business, or technical discipline or an equivalent combination of education, training, and experience.
- Demonstrated supervisory experience.
- Typically possess five or more years experience working in the field of workers' compensation.
- Self Insurance Certificate or currently working towards attaining the certificate.
- Demonstrated experience working with general workers' compensation claims management software systems.
- Demonstrated knowledge of FROI/SROI requirements.
- Demonstrated experience working with American Medical Association Guidelines for Permanent Disability Rating (5th Edition).
- Demonstrated ability to achieve results through others by providing leadership and resource planning including prioritizing activities, delegating and monitoring the progress of assignments, and holding employees accountable for results.
- Demonstrated ability to manage talent and create effective teams by selecting and developing employees to fill talent gaps.
- Demonstrated ability to motivate self and others to overcome obstacles and achieve goals.
- Demonstrated ability to accurately analyze information and make sound decisions that have considerable business impact on day-to-day operations.
- Demonstrated experience developing and implementing strategic plans that have a small to moderate impact on the organization, and facilitating forums to capture the stakeholder requirements.
- Demonstrated proficiency with PC applications, including Microsoft Word, Excel, and PowerPoint.
- Must demonstrate the ability to integrate work across relevant areas, develop the business and services to enhance customer satisfaction and productivity, manage risks and safety appropriately, manage information, and provide exceptional service to internal and external customers.
- Must demonstrate effective results delivery and team building, as well as the ability to stay current with relevant technology and innovation.
- Must demonstrate strong ethics, influence and negotiation, interpersonal skills, communication, and the ability to effectively manage stress and engage in continuous learning.
COMMENTS: Additional testing may be required as part of the selection process for this position. Candidates for this position must be legally authorized to work directly as employees for any employer in the United States without visa sponsorship.
Typical Responsibilities:
The successful candidate will manage a workers' compensation claims staff to administer benefits pursuant to statutory and regulatory requirements. The successful candidate will perform the following: manage case litigation, high value settlements, investigations, third party mediation, and excess insurance reporting requirements; manage Medicare-Set-Aside and fraud reporting requirements; conduct file reviews and reserve analyses' on high value cases; develop workflows, training and contribute to departmental business plans; provide close direction or oversight of work performed and desired results; select staff and manage employee performance and development by conducting performance planning and reviews, coaching employees, and carrying out disciplinary action when necessary; recommend and/or approve departmental policies and procedures and assist in the development of department policies and procedures; develop business plans, objectives, and initiatives for the organization in alignment with business strategy and customer requirements; assist in the development of initiatives for corporate strategic plans and objectives; and perform other duties and responsibilities as assigned.
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Edison International is an Equal Opportunity Employer.
