Sr. Claims Manager, Workers’ Compensation

RiverStone International•,

7h•$88,000 - $146,000•Hybrid

About The Position

We are seeking a Senior Manager, Workers’ Compensation Claims with 10+ years of multi-jurisdictional experience managing complex, high-exposure claim portfolios. This individual will bring deep expertise in overseeing TPA programs, ensuring regulatory compliance, and directly handling litigated matters. The role requires strong leadership capabilities to guide adjusters, manage reserving practices, and develop strategic approaches to risk mitigation and claim resolution.

Requirements

10+ years of workers’ compensation claims experience, including demonstrated leadership or management responsibility
Extensive experience managing claims across multiple jurisdictions, with a strong understanding of varying regulatory environments
Deep expertise in complex claim resolution, including leading settlement negotiations, developing Medicare Set-Aside (MSA) strategies, and implementing structured settlements
Appropriate state adjuster licensure (e.g., California SIP, Connecticut, New Hampshire, Rhode Island) or ability to obtain
Strong technical acumen in medical evaluation, liability assessment, and litigation management, combined with excellent written and verbal communication skills
Proven ability to lead, develop, and motivate teams, driving high performance and consistent outcomes
Highly analytical, with the ability to assess claim trends, interpret data, and evaluate financial and operational risk
Must be legally authorized to work in United States.

Nice To Haves

Bachelor’s degree preferred

Responsibilities

Independently manage a portfolio of complex, litigated, high-exposure and indemnity Workers’ Compensation claims, driving strategy through to resolution
Provide day-to-day guidance, coaching, and mentorship to claims staff (adjusters/examiners), supporting effective decision-making and team performance
Build and maintain strong client relationships, serve as a primary point of contact for key accounts, and ensure delivery aligns with service expectations and agreements
Ensure adherence to applicable state regulations, internal audit standards, and industry best practices across all claims activity
Develop, analyze, and communicate key performance metrics, trends, and insights to internal and external stakeholders
Oversee and manage relationships with external vendors, ensuring quality, cost-effectiveness, and alignment with service standards
Partner closely with TPAs to manage program performance, optimize processes, and ensure consistent, high quality claims handling