Resources

Workers' Compensation Claims Manager (City of Sacramento)

IDEAL CANDIDATE STATEMENT

The City of Sacramento is seeking a highly skilled and responsive Workers’ Compensation Claims Manager to perform complex managerial and analytical work in the management and administration of the Workers’ Compensation Unit, located in the Risk Management Division of the Human Resources Department. This position provides professional technical assistance to the Risk Manager and the Human Resources Director.

This position develops and directs the City of Sacramento workers' compensation program; administers, coordinates and supervises the processing, evaluation and resolution of workers' compensation claims; develops, implements and evaluates procedures and technical systems; and assures Federal, State, and City of Sacramento compliance with applicable laws, ordinances and codes.

The ideal candidate will possess a Certificate of Achievement of the Self-Insurance Administrator's Examination, and experience is highly desirable in the following areas:

1. State of California Workers’ Compensation laws, administrative regulations, and claimsadjusting procedures.
2. Public administration, management, and supervision.
3. PERS law, including industrial disability retirements.
4. Medical and legal terminology relating to workers’ compensation matters.
5. Sound financial and technical records management.
6. Permanent disability rating.
7. Self-insured programs.
8. Technical report writing.
9. Workers’ compensation claims administration software.
10. Recent workers’ compensation reforms.
11. Claim reserving.
12. Workers’ Compensation Appeals Board procedures.
13. Litigation management.

THE POSITION

Under general direction, the Workers' Compensation Claims Manager plans, organizes, administers, and supervises the City's self-administered Workers' Compensation Program, including reviewing and processing claims, participating in settlement negotiations, recommending loss control strategies, preparing required reports, and monitoring and evaluating program activities to ensure the delivery of quality services and conformance of applicable laws and regulations.

DISTINGUISHING CHARACTERISTICS

This single-position management classification is responsible for developing, interpreting, implementing, and enforcing existing policy and methods. The Workers' Compensation Claims Manager is distinguished from the Workers' Compensation Claims Supervisor in that the former has overall responsibility for the Workers' Compensation unit while the Workers' Compensation Claims Supervisor supervises, assigns, reviews and participates in the work activities of a Workers' Compensation work team.

SUPERVISION RECEIVED AND EXERCISED

General direction is provided by higher-level staff. Responsibilities include the direct and indirect supervision of professional, technical and clerical personnel.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The following duties are typical for this classification. The incumbent may not perform all the listed duties and/or may be required to perform additional related duties from those set forth below to address business needs and changing business practices.

• Plan, organize, monitor, administer, and supervise the City's Workers' Compensation Program, including developing, recommending and implementing policies and procedures; reviewing and processing claims and legal documents; participating in settlement negotiations; recommending and implementing loss prevention strategies, goals and objectives; instructing City staff on workers' compensation issues; and ensuring conformance to applicable laws and regulations while maintaining a high level of customer service.
• Supervise assigned staff, including the selection, training and evaluation of personnel; providing and coordinating staff training; working with employees to correct deficiencies; and implementing discipline and termination procedures.
• Supervise the management of employee injury cases by adhering to all excess carrier guidelines; investigate or oversee the investigation of claims; and consult with appropriate parties to develop strategies for specific cases.
• Participate in budget preparations and monitor expenditures; determine the extent of the City's liability; recommend and negotiate claim settlements; and establish reserves for anticipated costs.
• Stay abreast of trends and innovations in the field of workers' compensation administration and legislative and regulatory issues at the state and federal level.
• Identify, evaluate and assess probability and severity of losses; and, develop, implement and monitor citywide cost containment strategies to prevent and minimize losses.
• Oversee and ensure an efficient records maintenance system for workers' compensation claims and related information, data and activities.
• Provide staff assistance to higher-level staff; conduct research and studies; and prepare and present staff reports and other correspondence as appropriate.
• Develop and coordinate return-to-work plans; coordinate and monitor rehabilitation plans for injured employees; and evaluate results of return-to-work medical examinations and make appropriate determinations.
• Interface with physicians, attorneys, employees and management staff; and, make recommendations regarding medical aspects of retirement decisions.
• Respond to and resolve difficult and sensitive inquiries and complaints; evaluate problems and take appropriate action to resolve issues/concerns; and advise injured employees of their benefits.
• As a designated representative, attend workers' compensation hearings; manage and seek reimbursement from third party subrogation cases; attend and lead meetings to discuss workers' compensation issues; and represent department before public and private agencies, retirement boards and appeal boards.
• Complete required reports and records; authorize medical and permanent and temporary disability compensation payments and/or reimbursements.

NON- ESSENTIAL DUTIES

• Conduct citywide and/or specific departments training as needed.
• Issue appropriate letters for and schedule interactive process meetings.
• Determine and coordinate timecard corrections.
• Copy and complete referrals to defense attorneys and impacted parties.
• Accept subpoenas, prepare and send files to a copy service vendor.

QUALIFICATIONS

Knowledge of:

• Pertinent federal, state and local laws, codes and safety regulations, including the State Labor Code, Workers' Compensation and Americans with Disabilities Act laws, Occupational Safety Health Administration, and employment laws, procedures and regulations.
• Administrative principles and methods, including goal setting, program and budget development, work planning, and organization.
• Principles and procedures of report preparation.
• Jurisdictions, functions and procedures of the Workers' Compensation Appeals Board.
• Research, statistical and financial analysis.
• Rules and regulations of applicable retirement plans.
• Civil laws as applied to third-party workers' compensation cases.
• Medical and technical terminology used in industrial injury cases.
• Principles and procedures of recordkeeping.

Skill in:

• Managing multiple tasks and deadlines.
• Providing customer services for high profile and politically sensitive situations.
• Writing.
• Public speaking.
• Standard office practices and procedures, including the operation of modern office equipment such as computers, computer applications, and software programs relevant to assigned duties.

Ability to:

• Interpret, apply and explain federal, state and local laws, codes, regulations and proceedings and ensure compliance.
• Review, negotiate and approve a variety of insurance claims and settlements.
• Plan, organize, and direct a Workers' Compensation Program for a workforce of 1,000employees or greater.
• Research, analyze, and make sound and creative recommendations relating to workers' compensation claims and administrative problems.
• Represent the department effectively in meetings, including making presentations.
• Communicate clearly and concisely, both orally and in writing.
• Maintain accurate and complete records.

EXPERIENCE AND EDUCATION

Any combination of experience and education that would provide the required knowledge and abilities is qualifying. A typical way to obtain the knowledge and abilities would be:

Experience:
Seven years of combined workers' compensation adjuster or examiner and supervisory experience.

-AND-

Education:
Possession of a Bachelor's degree from an accredited college or university.

Substitution:
Additional qualifying supervisory experience may substitute for the required education on a year-for-year basis.

PROOF OF EDUCATION

Should the combination of experience/education you are using to qualify for this position include education, then proof of said education such as but not limited to university/college transcripts, certificates, and degrees must be submitted to the City of Sacramento Employment Office as an attachment(s) to the online application, faxed to (916) 596-1556, or emailed to employment@cityofsacramento.org by the final filing deadline. If submitting via fax/email, please include your name and Job #001927-20-HRon your documents. Unofficial documents and/or copies are acceptable.

An applicant with a college degree obtained outside the United States must have education records evaluated by a credentials evaluation service. This evaluation must be submitted
by the final filing deadline.

SPECIAL QUALIFICATIONS

Driver License:
Possession of a valid California Class C driver license at the time of appointment. Individuals whodo not meet this requirement due to physical disability will be reviewed on a case-by-case basis.

License or Certificate:
Possession of a certificate to administer a self-insured workers' compensation program for a publicentity issued by the State of California Department of Industrial Relations at the time ofappointment.

PHYSICAL DEMANDS AND WORKING ENVIRONMENT

The conditions herein are representative of those that must be met by an employee tosuccessfully perform the essential functions of this job. Reasonable accommodations may bemade to enable individuals with disabilities to perform the essential job functions.

Environment:
Standard office setting; some travel from site to site.

Physical:
Sufficient physical ability to work in an office setting and operate office equipment.

Vision:
See in the normal visual range with or without correction; vision sufficient to read computerscreens and printed documents.

Hearing:
Hear in the normal audio range with or without correction.

THE SELECTION PROCEDURE

Please note, the City of Sacramento's preferred method of communication with applicants is via e-mail. As such, please ensure you verify the e-mail address on your application, and check your e-mail frequently, including your spam and junk folders. All e-mail notifications can also be accessed through the governmentjobs.com applicant inbox.

1. Application: (Pass/Fail) – All applicants must complete and submit online a City of Sacramento employment application by the final filing deadline;

• Employment applications must be submitted online; paper applications will not be accepted.
• Employment applications will be considered incomplete and will be disqualified:
• If applicants do not list current and past job-related experience in the duties area of the "Work Experience" section. Note: Qualifying experience is based on 40 hours per week (pro-rated if less than 40 hours/week).
• If "see resume" is noted in the "Work Experience" section; a resume will not substitute for the information required in the "Work Experience" section.
• Position/job titles will not be considered in determining eligibility for meeting the minimum qualifications for this position.
• Proof of education such as, but not limited to, university/college transcripts and degrees must be submitted online with your application, emailed to employment@cityofsacramento.org, or sent to the Employment Office by fax by the final filing deadline.

2. Supplemental Questionnaire: (Pass/Fail) – In addition to the City of Sacramento employment application, all applicants must complete and submit online responses to the supplemental questionnaire to the City of Sacramento Employment Office by the final filing deadline;

• Responses to the supplemental questionnaire must be submitted online; paper questionnaire will not be accepted.
• Incomplete supplemental questionnaire will not pass the review process; omitted information cannot be considered or assumed.
• A resume will not substitute for the information required in the supplemental questionnaire. Possession of the minimum qualifications is not necessarily a guarantee for further advancement in the selection process.

3. Screening Committee:(Pass/Fail) - Human Resources will evaluate employment applications for the minimum qualifications stated on the job announcement.

4. Interview Process: Human Resources will forward qualified applications to the hiring department. Those determined to be the most qualified candidates will be invited to participate in an interview process.

5. Conditional Hire: Upon receipt of a conditional offer, the selected candidate must complete and pass LiveScan/fingerprinting. If applicable, candidates may also need to pass a pre-employment medical exam, controlled substance and/or alcohol test, and possess any required licensure or certification prior to receiving a start date from the Department. Failure to meet these prerequisites will be grounds for withdrawal of your conditional offer of employment.

QUESTIONS:

For questions concerning this job announcement and the application process:

• Please visit https://www.governmentjobs.com/Home/ApplicationGuide for a comprehensive, step-by-step guide to the application process.
• For technical support between 6 AM - 5 PM PT, contact Live Application Support at 855-524-5627.·
• Send an email to employment@cityofsacramento.org; or
• Call the Human Resources Department at (916) 808-5726

EOE