Workers Compensation Program Specialist Senior

OCTA; Town of Florida (NY); On-site; USD 92,000 - 126,000; Full time

Job summary

OCTA is seeking a Senior Workers’ Compensation Program Specialist to lead the design, implementation, and oversight of the agency’s workers’ compensation claims program. You will act as a subject-matter expert, shaping policies, performance metrics, and cost‑containment measures while ensuring compliance with applicable laws.

In this exempt role (salary grade 195), you will manage complex claims, oversee the TPA, and collaborate with legal, medical providers, and internal stakeholders.

Qualifications

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

Responsibilities

• Serve as an organizational expert on workers’ compensation policies, laws, practices, and regulatory requirements.
• Develop and implement workers’ compensation program goals, objectives, policies, and advanced cost-containment strategies.
• Provide strategic oversight of the workers’ compensation TPA, including performance reviews and audits.
• Manage complex and high-stakes claims, settlements, employer-level investigations, and regulatory matters.
• Lead initiatives such as the Transitional Work Program and identify opportunities to improve program effectiveness and efficiency.
• Develop KPIs, benchmarks, and data analytics to evaluate program performance and reduce costs.

Skills

Workers' compensation claims

Data analytics

Financial oversight

Stakeholder management

Regulatory compliance

Education

Bachelor's degree in Finance, Business Administration, or related field

Tools

Origami Claims Management System

Job description

Job Description

Under 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 Do

• Serve as an organizational expert on workers’ compensation policies, laws, practices, and regulatory requirements
• Develop and implement workers’ compensation program goals, objectives, policies, and advanced cost-containment strategies
• Provide strategic oversight of the workers’ compensation TPA, including performance reviews and audits designed to optimize claims outcomes
• Manage complex and high-stakes claims, settlements, employer-level investigations, and regulatory matters
• Lead initiatives such as the Transitional Work Program and identify opportunities to improve program effectiveness and efficiency
• Develop key performance indicators (KPIs), benchmarks, and data analytics to evaluate program performance, identify injury trends, and reduce costs
• Lead financial analyses and reporting, including cost-benefit analyses, reconciliation improvements, and return-on-investment measurements
• Prepare and present financial, claims, and program performance reports to executive leadership
• Support the implementation and effective use of claims management technology, including the Origami Claims Management System
• Ensure required Department of Industrial Relations reporting is completed accurately and timely
• Develop and maintain effective partnerships with legal counsel, medical providers, TPAs, and other industry partners
• Author and communicate policy and program updates to employees, leadership, and other stakeholders
• Advise employees on workers’ compensation matters and champion timely, effective support for injured employees
• Mentor and coach team members and stakeholders to strengthen workers’ compensation knowledge and promote continuous improvement
• Represent OCTA on workers’ compensation matters at meetings, audits, presentations, and external forums
• Support safety initiatives and related training activities as needed

What We’re Looking For

• Bachelor’s degree in Finance, Business Administration, or a related field, or an equivalent combination of education and experience
• Minimum of five years of workers’ compensation claims experience
• State of California Self-Insured Certificate required
• Advanced knowledge of workers’ compensation laws, claims practices, policies, and regulatory requirements
• Experience overseeing third-party claims administrators and working with legal counsel, medical providers, and other business partners
• Demonstrated ability to manage complex claims and high-stakes workers’ compensation matters
• Strong analytical skills with the ability to use claims and financial data to identify trends, evaluate performance, and recommend solutions
• Experience developing KPIs, performance measures, reports, and cost-containment strategies
• Strong problem-solving skills and a solutions-oriented approach to complex claims and program challenges
• Excellent written, verbal, presentation, and relationship-building skills
• Ability to lead initiatives, influence stakeholders, and mentor others without direct supervisory authority
• Experience with claims management technology, such as Origami, is valuable for success in this role

Why You’ll Love It Here

• Serve as a subject matter expert and help shape the direction of OCTA’s workers’ compensation program
• Make a meaningful impact by improving outcomes and supporting injured employees
• Use data, technology, and analytics to drive smarter claims management and cost-containment strategies
• Lead program improvements and initiatives that enhance efficiency and organizational performance
• Collaborate with executive leadership, legal counsel, medical providers, TPAs, and professionals across the agency
• Apply your expertise to complex, high-impact workers’ compensation challenges in a mission-driven public transportation organization

Join a team where innovation, integrity, and strategic thinking are valued.

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.