Description
Plan, direct, and coordinate the organization's workers' compensation program, including claims management, compliance, return-to-work, and carrier/TPA relationships.
- • Advise management on workers' compensation laws, OSHA recordkeeping, injury reporting, and anti-retaliation requirements.
- • Direct preparation and distribution of information to inform employees and supervisors about injury reporting, claims, and return-to-work policies.
- • Administer, direct, and review workers' compensation claims programs, including post-acquisition program integration across states.
- • Integrate workers' compensation and safety procedures into new-employee orientations.
- • Plan, direct, and supervise staff and TPAs handling claims, investigations, and case management.
- • Identify and implement return-to-work, light-duty, and accommodation options to reduce lost time and support recovery.
- • Design, evaluate, and modify workers' compensation policies to remain current, cost-effective, and compliant with state regulations; align with FMLA/ADA practices.
- • Analyze loss data, experience modification factors, and premium structures to develop cost-control strategies.
- • Formulate policies and procedures for incident reporting, investigation, claims handling, panel providers, and stakeholder communication.
- • Mediate between carriers/TPAs, medical providers, and employees to resolve claim issues and questions.
- • Fulfill all state reporting requirements, including first reports of injury, OSHA log coordination, and insurer notifications.
- • Maintain claims records and compile statistical reports on injuries, costs, lost time, and trends.
- • Analyze injury and claims data to identify root causes and recommend prevention strategies with Safety and Operations.
- • Develop and implement process improvements for incident reporting, claims management, and return-to-work workflows.
- • Negotiate and manage agreements with carriers, TPAs, nurse case managers, IME vendors, and defense counsel; oversee subrogation and fraud investigations.
- • Represent the organization at workers' compensation hearings, mediations, audits, and insurer reviews.
- • Partner with HR and Safety to maintain accurate job analyses and physical demand descriptions to support return-to-work and claims.
- • Develop tools and training to guide supervisors through incident reporting, investigation, and return-to-work decisions.
- • Prepare and manage budgets and reserves for workers' compensation premiums, deductibles, and claim expenses.
- • Forecast claims frequency and costs to inform insurance purchasing, staffing, and loss-reserve planning.
- • Contract with occupational health clinics, panel physicians, and rehabilitation providers.
- • Monitor state legislation, case law, and industry trends affecting workers' compensation and leave coordination.
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Management & Entrepreneurship
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Tasks & skills:
O*NET occupational data (work activities, skills, knowledge).
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This site includes information from O*NET by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA), used under the CC BY 4.0 license. Career Clutch has modified some of this information for student readability. USDOL/ETA has not approved, endorsed, or tested these modifications. O*NET® is a trademark of USDOL/ETA.
Last reviewed: Jan 2026
