Program Consultant, Worker's Compesation

Accountabilities: The Program Consultant will oversee workers' compensation program operations, coordinate claims management activities, and develop strategies to improve service quality, compliance, and financial performance. Key responsibilities include: Workers' Compensation Program Management: Design, implement, and oversee comprehensive workers' compensation programs, ensuring alignment with organizational objectives and applicable regulatory requirements. Coordinate and lead regular claims reviews throughout the year, ensuring follow-up actions are documented and completed according to agreed plans. Monitor new claims, subrogation opportunities, claim delays, denials, and reserve adjustments, recommending corrective actions where necessary. Collaborate with local operations teams and third-party administrators (TPAs) to facilitate information exchange, resolve program issues, and maintain service quality. Oversee state-specific workers' compensation programs, including monopolistic state requirements and premium payment coordination, such as Ohio BWC. Claims Oversight and Litigation Management: Monitor ongoing claims activity, including significant loss cases, and manage legal calendars to ensure appropriate follow-up. Coordinate litigation activities, oversee defense attorney panels, monitor legal performance, and implement improvements when needed. Track and coordinate legal plans of action related to workers' compensation claims. Monitor legislative, technical, and legal developments affecting workers' compensation programs and communicate relevant updates to local operations. Program Advocacy and Stewardship: Act as a program advocate by coordinating stewardship initiatives and benchmarking exercises to evaluate and improve program performance. Develop educational resources and deliver training sessions to local operations on program-specific requirements, technical developments, and industry best practices. Vendor and Provider Management: Manage relationships with medical provider networks, monitor service quality, coordinate provider changes, and conduct provider interviews. Address vendor inquiries, investigate service issues, and coordinate the resolution of outstanding or unpaid invoices. Review and update service level agreements and special account handling instructions to improve service delivery. Data Analytics and Continuous Improvement: Analyze claims data and loss trends to identify cost-saving opportunities, operational inefficiencies, and areas for program improvement. Coordinate claims audits and support continuous improvement initiatives. Collect, evaluate, and report relevant performance data to support program objectives and informed decision-making. Additional Program Support: Support manufacturing and Owner-Controlled Insurance Program (OCIP) claims oversight, including business unit claims reviews and annual stewardship activities. Develop, maintain, and update service instructions, program guidelines, and supporting documentation. Coordinate with Safety and Human Resources departments to align claims management practices with organizational safety initiatives and ensure compliance across applicable jurisdictions. Requirements The ideal candidate will bring extensive workers' compensation expertise, strong analytical capabilities, and proven experience managing complex claims and multi-state programs. The following qualifications and competencies are expected: At least seven years of experience in workers' compensation program management, consulting, or claims administration. In-depth knowledge of state and federal workers' compensation laws, regulations, and program requirements. Demonstrated experience managing complex claims, litigation processes, and relationships with third-party administrators, vendors, and medical providers. Strong understanding of claims oversight, litigation management, subrogation, reserve changes, and cost-containment strategies. Experience analyzing claims data, identifying loss trends, conducting benchmarking exercises, and developing program improvement recommendations. Familiarity with monopolistic state workers' compensation programs, particularly Ohio BWC, and multi-state program oversight is preferred. Proven ability to coordinate claims reviews, audits, legal action plans, and provider performance assessments. Strong communication and interpersonal skills, with the ability to collaborate effectively across internal departments and external stakeholders. Experience developing training materials, delivering educational sessions, and communicating regulatory or technical changes. Excellent organizational and project management skills, with the ability to manage multiple priorities and complex program requirements. Bachelor's degree in Risk Management, Insurance, Business Administration, or a related discipline. Advanced degree or relevant professional certifications, such as Associate in Risk Management (ARM) or Chartered Property Casualty Underwriter (CPCU), are considered an advantage. Benefits Competitive annual base salary ranging from $115,000 to $135,000 USD, depending on experience, education, skills, qualifications, and geographic location. Eligibility for an annual discretionary performance-based bonus through an incentive plan. Remote working arrangement. 401(k) retirement savings plan with employer contributions. Employee stock purchase plan. Potential eligibility for long-term incentive awards. Comprehensive medical, dental, and vision insurance. Short-term disability coverage and optional long-term disability insurance. Employee and dependent life insurance, including supplemental life and accidental death and dismemberment (AD&D) coverage. Health Savings Account (HSA) and healthcare and dependent care reimbursement accounts. Paid time off, including 15 vacation days annually, 12 paid holidays, and sick leave in accordance with applicable state and local laws. Various types of leave of absence. Adoption assistance and tuition assistance programs. Commuter benefits. Optional personal insurance policies. Employee Assistance Program (EAP), including free counseling sessions. Additional benefits subject to applicable plan documents and eligibility requirements. How Jobgether works: We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team. We appreciate your interest and wish you the best! Why Apply Through Jobgether? Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time. #LI-CL1