Workers Compensation Program Specialist Senior

Octa; Orange (CA); On-site; USD 92,000 - 126,000; Full time

Job summary

OCTA is seeking a Senior Workers’ Compensation Program Specialist to lead the implementation and administration of its workers’ compensation program and oversee the agency’s third-party administrator. The role develops strategies, KPIs, and cost-containment initiatives while ensuring compliance with workers’ compensation laws and requirements.

The ideal candidate will bring a Bachelor's degree, at least five years of claims experience, and strong analytic and communication skills.

Qualifications

• Bachelor's degree in Finance, Business Administration, or a related field; equivalent combination accepted.
• Minimum of five years of workers’ compensation claims experience.
• State of California Self-Insured Certificate required; advanced knowledge of laws, practices, and regulatory requirements.

Responsibilities

• Serve as organizational expert on workers’ compensation policies, laws, and regulatory requirements.
• Develop and implement program goals, policies, and cost-containment strategies.
• Provide strategic oversight of the workers’ compensation TPA, including performance reviews and audits.
• Manage complex claims, settlements, and regulatory matters; lead initiatives to improve efficiency.

Skills

Workers' comp knowledge

Data analytics

Stakeholder management

Regulatory compliance

Financial analysis

Education

Bachelor's degree in Finance/Business Administration

Tools

Origami

Job description

Job DescriptionUnder 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.This is an exempt position in salary grade 195: Min – $91,852.80 | Mid – $109,137.60 | Max – $126,401.60/year. The starting salary will be within this range based on qualifications.This posting will remain open until a candidate is selected.What You’ll DoServe as an organizational expert on workers’ compensation policies, laws, practices, and regulatory requirementsDevelop and implement workers’ compensation program goals, objectives, policies, and advanced cost-containment strategiesProvide strategic oversight of the workers’ compensation TPA, including performance reviews and audits designed to optimize claims outcomesManage complex and high-stakes claims, settlements, employer-level investigations, and regulatory mattersLead initiatives such as the Transitional Work Program and identify opportunities to improve program effectiveness and efficiencyDevelop key performance indicators (KPIs), benchmarks, and data analytics to evaluate program performance, identify injury trends, and reduce costsLead financial analyses and reporting, including cost-benefit analyses, reconciliation improvements, and return-on-investment measurementsPrepare and present financial, claims, and program performance reports to executive leadershipSupport the implementation and effective use of claims management technology, including the Origami Claims Management SystemEnsure required Department of Industrial Relations reporting is completed accurately and timelyDevelop and maintain effective partnerships with legal counsel, medical providers, TPAs, and other industry partnersAuthor and communicate policy and program updates to employees, leadership, and other stakeholdersAdvise employees on workers’ compensation matters and champion timely, effective support for injured employeesMentor and coach team members and stakeholders to strengthen workers’ compensation knowledge and promote continuous improvementRepresent OCTA on workers’ compensation matters at meetings, audits, presentations, and external forumsSupport safety initiatives and related training activities as neededWhat We’re Looking ForBachelor’s degree in Finance, Business Administration, or a related field, or an equivalent combination of education and experienceMinimum of five years of workers’ compensation claims experienceState of California Self-Insured Certificate requiredAdvanced knowledge of workers’ compensation laws, claims practices, policies, and regulatory requirementsExperience overseeing third-party claims administrators and working with legal counsel, medical providers, and other business partnersDemonstrated ability to manage complex claims and high-stakes workers’ compensation mattersStrong analytical skills with the ability to use claims and financial data to identify trends, evaluate performance, and recommend solutionsExperience developing KPIs, performance measures, reports, and cost-containment strategiesStrong problem-solving skills and a solutions-oriented approach to complex claims and program challengesExcellent written, verbal, presentation, and relationship-building skillsAbility to lead initiatives, influence stakeholders, and mentor others without direct supervisory authorityExperience with claims management technology, such as Origami, is valuable for success in this roleWhy You’ll Love It HereServe as a subject matter expert and help shape the direction of OCTA’s workers’ compensation programMake a meaningful impact by improving outcomes and supporting injured employeesUse data, technology, and analytics to drive smarter claims management and cost-containment strategiesLead program improvements and initiatives that enhance efficiency and organizational performanceCollaborate with executive leadership, legal counsel, medical providers, TPAs, and professionals across the agencyApply your expertise to complex, high-impact workers’ compensation challenges in a mission-driven public transportation organizationJoin a team where innovation, integrity, and strategic thinking are valued. Apply now to help advance OCTA’s workers’ compensation program and deliver effective, employee-focused solutions that support our workforce.OCTA is an equal employment opportunity employer that recruits, hires, and promotes qualified people without regard to race, color, religion, creed, ancestry, national origin, age, sex, pregnancy, gender, gender identity and/or expression, sexual orientation, marital status, medical condition, disability, genetic information, military and veteran status, or other legally protected status.