Workers Compensation Program Specialist Senior

OCTA • Orange, CA

2d • $91,853 - $126,402

About The Position

Under general guidance, the Senior Workers’ Compensation Program Specialist leads the implementation and administration of OCTA’s workers’ compensation claims program and provides oversight of the agency’s third-party administrator (TPA). Serving as an organizational subject matter expert, this role develops program strategies, policies, performance measures, and cost-containment initiatives while ensuring compliance with applicable workers’ compensation laws and requirements.
This position combines advanced claims expertise, data analytics, financial oversight, technology, and strategic relationship management to improve outcomes for injured employees and strengthen OCTA’s workers’ compensation program.

Requirements

• Bachelor’s degree in Finance, Business Administration, or a related field, or an equivalent combination of education and experience
• Minimum of five years of workers’ compensation claims experience
• State of California Self-Insured Certificate required
• Advanced knowledge of workers’ compensation laws, claims practices, policies, and regulatory requirements
• Experience overseeing third-party claims administrators and working with legal counsel, medical providers, and other business partners
• Demonstrated ability to manage complex claims and high-stakes workers’ compensation matters
• Strong analytical skills with the ability to use claims and financial data to identify trends, evaluate performance, and recommend solutions
• Experience developing KPIs, performance measures, reports, and cost-containment strategies
• Strong problem-solving skills and a solutions-oriented approach to complex claims and program challenges
• Excellent written, verbal, presentation, and relationship-building skills
• Ability to lead initiatives, influence stakeholders, and mentor others without direct supervisory authority

Nice To Haves

• Experience with claims management technology, such as Origami, is valuable for success in this role

Responsibilities

• Serve as an organizational expert on workers’ compensation policies, laws, practices, and regulatory requirements
• Develop and implement workers’ compensation program goals, objectives, policies, and advanced cost-containment strategies
• Provide strategic oversight of the workers’ compensation TPA, including performance reviews and audits designed to optimize claims outcomes
• Manage complex and high-stakes claims, settlements, employer-level investigations, and regulatory matters
• Lead initiatives such as the Transitional Work Program and identify opportunities to improve program effectiveness and efficiency
• Develop key performance indicators (KPIs), benchmarks, and data analytics to evaluate program performance, identify injury trends, and reduce costs
• Lead financial analyses and reporting, including cost-benefit analyses, reconciliation improvements, and return-on-investment measurements
• Prepare and present financial, claims, and program performance reports to executive leadership
• Support the implementation and effective use of claims management technology, including the Origami Claims Management System
• Ensure required Department of Industrial Relations reporting is completed accurately and timely
• Develop and maintain effective partnerships with legal counsel, medical providers, TPAs, and other industry partners
• Author and communicate policy and program updates to employees, leadership, and other stakeholders
• Advise employees on workers’ compensation matters and champion timely, effective support for injured employees
• Mentor and coach team members and stakeholders to strengthen workers’ compensation knowledge and promote continuous improvement
• Represent OCTA on workers’ compensation matters at meetings, audits, presentations, and external forums
• Support safety initiatives and related training activities as needed

Benefits

• Serve as a subject matter expert and help shape the direction of OCTA’s workers’ compensation program
• Make a meaningful impact by improving outcomes and supporting injured employees
• Use data, technology, and analytics to drive smarter claims management and cost-containment strategies
• Lead program improvements and initiatives that enhance efficiency and organizational performance
• Collaborate with executive leadership, legal counsel, medical providers, TPAs, and professionals across the agency
• Apply your expertise to complex, high-impact workers’ compensation challenges in a mission-driven public transportation organization
• Join a team where innovation, integrity, and strategic thinking are valued.

What This Job Offers

• Job Type: Full-time
• Career Level: Senior