Manager - Worker’s Compensation Claims (Risk Management)

City of Dallas•Dallas, TX

12d•$77,272 - $96,574

About The Position

The Workers’ Compensation Claims Manager manages and provides strategic oversight of the City’s workers’ compensation claims program and return-to-work (RTW) initiatives. The role ensures claims are handled efficiently, cost-effectively, and in compliance with applicable laws and regulations while supporting injured employees in recovering safely and returning to productive work. The Manager leads workers’ compensation coordinators and partners with City departments, third-party administrators (TPAs), workers’ compensation medical network providers, nurse case management, and other stakeholders. The position identifies ways to reduce claim costs and duration, improve outcomes, strengthen RTW practices, and promote consistent workplace injury management. The role also performs other duties as assigned.

Requirements

Five years of experience with the Texas Department of Insurance, Division of Workers’ Compensation.
Five years of progressive workers’ compensation claims management experience and self-insured workers’ compensation program experience.
Five years of experience with disability management, occupational health, absence management, or workplace accommodations.
Three years of supervisory/management or program leadership experience.
Demonstrated experience managing or overseeing a return-to-work, transitional-duty, disability management, or absence management program.
Strong knowledge of Texas workers’ compensation claims practices, regulations, medical management, disability management, and return-to-work principles.
Experience managing complex, litigated, and high-exposure claims.
Experience working with TPAs, defense counsel, medical providers, and other claims-related vendors.
Strong analytical and financial skills, including experience with claims reporting, reserves, loss trends, and program metrics.
Excellent communication, negotiation, problem-solving, and organizational skills.
Experience developing or implementing enterprise-wide RTW programs.
Experience using claims analytics and reporting tools to drive program improvements.
Ability to influence managers and operational leaders and build effective cross-functional partnerships.
Proficiency with Microsoft Office and claims management/reporting systems.
Valid driver’s license with a good driving record.
Bachelor’s degree in Risk Management, Business Administration, Human Resources, Occupational Health, Insurance, or a related field.
A qualifying master’s degree in Management, Leadership, Business Administration, Public Administration, or a related field may substitute for experience: two years for each of the stated five-year experience categories and one year for the supervisory or program leadership experience.

Nice To Haves

Experience working in management in municipal government or large public-sector organizations.
Active Texas All Lines Adjuster License.

Responsibilities

Oversee workers’ compensation claims from initial injury reporting through resolution and closure.
Lead, direct, and support claims staff and coordinators, ensuring claims are managed according to established standards and applicable regulations.
Monitor claim inventories, reserves, payments, medical treatment, indemnity exposure, litigation, and overall claim status.
Review complex, catastrophic, litigated, and high-exposure claims and establish appropriate action plans.
Partner with TPAs, defense counsel, medical providers, and other vendors to support effective claim management.
Review and evaluate claim reserves, settlement recommendations, litigation strategies, and financial exposure.
Monitor claim handling for compliance with applicable workers’ compensation laws, regulations, contractual requirements, and policies.
Identify trends in claim frequency, severity, duration, and cost and develop strategies to improve program performance.
Conduct periodic claim reviews with internal stakeholders and external claims administrators.
Ensure accurate and timely claims reporting, documentation, investigation, communication, and resolution.
Provide strategic oversight of the organization’s return-to-work and transitional-duty program.
Develop, implement, and maintain consistent RTW policies, procedures, guidelines, and best practices.
Partner with Human Resources, Safety, Occupational Health, managers, supervisors, and medical providers to facilitate safe and timely returns to work.
Establish processes to evaluate temporary work restrictions and identify appropriate transitional-duty assignments.
Ensure restrictions and accommodations are documented, communicated, monitored, and updated appropriately.
Monitor employees on temporary restrictions and ensure assignments remain consistent with current medical restrictions.
Establish escalation procedures for employees who face challenges returning to work or maintaining modified duty.
Collaborate with treating physicians and other medical professionals, as appropriate, to clarify restrictions and functional capabilities.
Track RTW metrics, including time away from work, modified-duty utilization, lost-time claims, days of disability, and successful return-to-work outcomes.
Identify barriers to successful RTW and develop solutions with business leaders and other stakeholders.
Educate managers and supervisors on RTW procedures, appropriate communication, temporary work assignments, and management of workplace restrictions.
Promote early intervention and proactive communication following workplace injuries.
Ensure RTW practices are applied consistently across locations and business units while accounting for legal and operational requirements.
Evaluate RTW program effectiveness and recommend improvements based on claims data, employee outcomes, and operational feedback.
Perform other duties as assigned.