Senior Workers’ Comp Claims Program Lead – PA & MI

Clemens Food Group; Hatfield Township (PA); Sur place; USD 110 000 - 160 000; Plein temps

Résumé du poste

Clemens Food Group seeks an experienced Workers’ Compensation Claims Manager to own our workers’ compensation claims program and strengthen how we manage complex claims, medical issues, and overall program performance.

This is an opportunity for a seasoned claims professional who enjoys getting into the details, making informed decisions, challenging the status quo when appropriate, and improving outcomes.

Qualifications

• 10+ years of substantive workers’ compensation claims-management experience.
• Strong Pennsylvania workers’ compensation claims expertise with experience managing claims across multiple jurisdictions.
• Demonstrated experience managing complex, disputed, litigated, and high‑exposure claims.
• Strong medical claims-management and investigation experience.
• Experience directing claims professionals or overseeing a third-party administrator.
• Experience collaborating with outside counsel on contested and litigated workers’ compensation claims.
• Ability to independently evaluate claim strategy, medical information, investigation findings, and resolution options.

Responsabilités

• Provide hands-on oversight of a high-volume workers’ compensation claims program, focusing on Pennsylvania and Michigan exposure.
• Evaluate complex, disputed, and high-exposure claims, including compensability, investigation, medical strategy, reserves, litigation, and settlement recommendations.
• Direct and challenge the TPA to ensure proactive claims handling, action plans, and timely progression toward resolution.
• Review medical information and coordinate with occupational health professionals to evaluate causation, treatment, work status, and resources.
• Evaluate recommendations from and collaborate with outside counsel to establish strategies for contested and litigated claims.
• Analyze claims data to identify frequency, severity, duration, and cost drivers and recommend program improvements.
• Partner with Safety, Occupational Health, and the business on investigations, injury trends, return-to-work opportunities, and claim-related improvements.
• Communicate claims insights, emerging risks, and improvement recommendations to internal stakeholders and leadership.

Connaissances

Claims management

Pennsylvania expertise

Complex claims handling

Data-driven decisions

Description du poste

Clemens Food Group seeks an experienced Workers’ Compensation Claims Manager to own our workers’ compensation claims program and strengthen how we manage complex claims, medical issues, and overall program performance.

This is an opportunity for a seasoned claims professional who enjoys getting into the details, making informed decisions, challenging the status quo when appropriate, and improving outcomes.