Workers' Compensation Program and Claims Manager

Denver Health and Hospital Authority•Denver, CO

7d•Onsite

About The Position

We are recruiting for a mission-driven Workers' Compensation Program and Claims Manager to join our team! We're with you for life’s journey. At Denver Health, purpose isn’t just something we believe in—it’s something we live every day, for life’s journey. Our Values Respect | Belonging | Accountability | Transparency Department Risk Management Job Summary Under minimum supervision, the Workers' Compensation and Claims Manager oversees the administration and day-to-day operations of the health system's workers' compensation program, managing claims alongside the third-party administrator from the initial report of injury through final resolution. Serving as a subject matter expert for workers' compensation and return-to-work matters, the incumbent ensures compliance with applicable laws, regulations, and organizational policies while serving as the primary liaison among injured employees, managers, HR, Legal, Risk Management, medical providers, insurance carriers, third-party administrators (TPAs), and other external partners. The position is responsible for effective claims management, employee support, risk reduction, cost containment, safety and loss prevention, and continuous program improvement. In addition, this role works closely with Emergency Medical Services (EMS) and oversees property claims throughout the health system, coordinating with facilities, engineering, and insurance. This position supports in-house legal counsel with other claims, including employment and auto claims.

Requirements

Bachelor's Degree Required or High School Diploma or GED and 4-6 additional years of experience Required
4-6 years 5+ years of experience in workers' compensation claims, coordination, legal or administration Required
1-3 years 2+ years legal/legal adjacent experience Required
Advanced knowledge in the Workers' Compensation industry, laws and regulatory compliance.
Exhibit good judgment, strong analytical skills and evaluation of risk in order to develop and maintain effective loss prevention/control processes, including the management of an encompassing insurance program;
Possess excellent interpersonal skills to effectively work with all levels of organization staff and at times individuals outside of the organization to effectuate change and produce results;
Manage non-clinical claims brought against the organization;
Effectively educate and train staff with respect to risk management loss prevention/control principles;
Be highly self-motivated with the ability to function independently and as part of a team in a fast-paced environment with minimal supervision and direction.
Strong written and verbal communication skills.
Knowledge and understanding of property claims and management.
Claims data analysis and cost management.
Promotes positive interpersonal (customer) relationships with fellow employees, physicians, other clinical staff, patients and visitors. Treats these individuals with courtesy, dignity, empathy and respect; consistently displays courteous and respectful verbal and non-verbal communications
Adheres to, complies with, and demonstrates support for the mission and values of Denver Health.
Supports and adheres to the Denver Health Values, including: transparency, accountability, respect, and belonging.
Ensures confidentiality of patient and employee information by creating and maintaining a secure and trusting environment by not sharing information learned on the job, except when necessary in the performance of the job responsibilities or to improve a patient’s care or claims’ handling process.

Responsibilities

Under indirect supervision, coordinates, administers, and oversees all phases of the self-insured workers' compensation program from the initial report of injury through claim closure.
Works directly in claims management software including ICE.
Reviews initial injury report and coordinates reporting system technologies, including the Denver Health “OUCH” line and the occupational health clinic.
Serves as primary point of contact for injured employees including lost time inquiries and workers' compensation payroll matters.
Coordinates with insurance carriers, Third Party Administrator, and occupational health clinic to facilitate timely claim progression.
Administers and coordinates return-to-work and modified duty programs in partnership with employees, managers, and Leave of Absence office.
Ensures compliance with workers' compensation laws, regulations, and reporting requirements.
Develops policies, procedures, training materials, and loss prevention initiatives through strategic partnerships with key stakeholders.
Provides education and guidance to departments regarding potential exposure, mitigating risk, and safety provisions, including the implementation of such.
Analyzes claims, loss statistics, and injury trends to identify risk exposures, prevention opportunities, program trends, and cost-reduction strategies.
Manages claim-related vendors and external partners, monitors carrier and TPA performance, addresses service issues, and reports claims to excess carriers when applicable.
Maintains accurate and confidential claim records and documentation, including generating accurate reports and claims data from the claims management system for purposes of insurance, safety and finances.
Obtains certificates of insurance upon request.
Manages the health care system's property claims and incidents.
Facilitates and assists with property inspections by the property carrier.
Maintains a real property inventory and valuation and provides changes to the broker.
Coordinates investigations with facilities, engineering, carriers, and brokers to respond, report, and manage system response to property damage.
Reports claims to the insurance company per policy requirements.
Generates detailed reports on property losses and claims history as requested.
Develops and implements new approaches to loss prevention, safety and control.
Evaluates area of loss and implements/coordinates corrective actions.
Partner with the Director of Safety and Environment of Care and other key stakeholders to mitigate potential safety and hazardous concerns.
Assists in managing commercial automobile, general liability, and other assigned claims.
Coordinates with insurers, attorneys, adjusters, and stakeholders as needed.
Conducts investigations and analyzes liability and exposure.
Supports settlement, mediation, and litigation management.
Supports in-house legal counsel in employment-related claims, including intake of new EPL claims and opening and closing files in the claims management system.
Reports the claim to the EPL carrier and generates a legal hold if applicable.
Supports claim management as needed, including updating the claims management system, sending engagement letters, and processing defense counsel invoices.
Generates detailed reports on EPL losses and claims history as requested.

Benefits

Generous paid time off
Fully paid parental leave
Exceptional retirement contributions
Comprehensive health coverage
Nationally recognized well-being programs
Tuition assistance
Career advancement pathways
Professional development
Meaningful financial advantages
Loan forgiveness eligibility
Employer contributions
Paid time off starting at 28 days per year, inclusive of vacation, personal/sick, and 7 Holidays
100% paid parental leave up to 6 weeks
Immediate eligibility for retirement plans with employer contribution up to 9.5%
Generous medical, dental, vision plans in addition to employer paid disability and life insurance.
Comprehensive well-being programs including on-site employee fitness center located on Denver Health main campus and nationally recognized RESTORE Center
Free RTD EcoPass (public transportation)
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education, coaching, and professional development opportunities through the Workforce Development Center (WFDC) that support internal career growth and advancement pathways
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer+ free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer