Manager - Worker’s Compensation Claims (Risk Management)

dallascityhall; Dallas (TX); On-site; USD 90,000 - 140,000; Full time

Job summary

The City of Dallas seeks a Workers' Compensation Claims Manager to lead the program and RTW initiatives, guiding strategic claim handling and ensuring regulatory compliance while supporting injured employees in recovery and return to work.

You will oversee claims staff, coordinate with TPAs, monitor reserves and treatment, and develop cost-reduction strategies for consistent injury management across departments.

Qualifications

• Experience managing a return-to-work, disability management, or absence-management program.
• Strong knowledge of Texas workers' compensation regulations, medical management, and RTW principles.
• Experience handling complex, litigated, and high-exposure claims.
• Experience working with TPAs, defense counsel, medical providers, and other claims vendors.
• Strong analytical and financial skills with claims reporting, reserves, and trends.
• Excellent communication skills.

Responsibilities

• Oversee the workers' compensation claims program from initial injury reporting through resolution and closure.
• Lead claims staff and coordinators; ensure compliance with standards and regulations.
• Monitor reserves, payments, medical treatment, indemnity exposure, litigation, and overall claim status.
• Review complex, catastrophic, litigated, and high-exposure claims and develop action plans.
• Collaborate with TPAs, defense counsel, medical providers, and other vendors to ensure effective claim management.
• Review reserves, settlement recommendations, and litigation strategies while assessing financial exposure.
• Monitor claim reporting, documentation, investigation, and timely resolution.

Skills

RTW program

Texas WC knowledge

Litigated claims

TPA coordination

Analytical skills

Communication

Job description

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Job Summary

Job Description

Overview

The Workers' Compensation Claims Manager manages and provides strategic oversight of the city's workers' compensation claims program and return-to-work (RTW) initiatives. This position ensures workers' compensation claims are managed efficiently, cost-effectively, and in compliance with applicable laws and regulations while supporting injured employees in achieving safe and timely recovery and returning to productive work. The Manager provides leadership to workers' compensation coordinators and serves as a key partner to city departments, third-party administrators (TPAs), workers' compensation medical network providers, nurse case management, and other stakeholders. The role identifies opportunities to reduce claim costs and duration, improve claim outcomes, strengthen RTW practices, and promote a consistent approach to workplace injury management.

Essential Functions

Workers Compensation Claims Management

• Oversee the workers' compensation claims program from initial injury reporting through resolution and closure.
• Provide leadership, direction, and support to claims staff and coordinators and ensure 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 ensure 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 company policies.
• Identify trends in claim frequency, severity, duration, and costs and develop strategies to improve overall program performance.
• Conduct periodic claim reviews with internal stakeholders and external claims administrators.
• Ensure accurate and timely claims reporting, documentation, investigation, communication, and resolution.

Return-to-Work Program Oversight

• Own and 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 employee returns to work.
• Establish processes for evaluating temporary work restrictions and identifying appropriate transitional-duty assignments.
• Ensure restrictions and accommodations are appropriately documented, communicated, monitored, and updated.
• Monitor employees on temporary restrictions and ensure work assignments remain consistent with current medical restrictions.
• Establish appropriate escalation procedures for employees who experience challenges returning to work or maintaining modified duty.
• Collaborate with treating physicians and other medical professionals, as appropriate, to obtain clarification of 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 in collaboration with business leaders and other stakeholders.
• Educate managers and supervisors regarding 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 applicable legal and operational requirements.
• Evaluate the effectiveness of the RTW program and recommend improvements based on claims data, employee outcomes, and operational feedback.

Knowledge and Skills

• 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 comm