JOB PURPOSE STATEMENT: Under the direction and supervision of the Assistant Superintendent of Business Services, the Director of Risk Management and Benefits oversees all risk management functions, including managing and directing the workers’ compensation and property/liability insurance programs, which includes reviewing claims and coordinating settlement with outside counsel; assuring compliance with the complex risk management program in claims, and managing, preventing, or reducing loss exposure on anticipated and recurrent losses; assisting with safety programs for the District; establishing and analyzing all relevant data to effect necessary control plans in order to bring all claims to equitable conclusion for employees and District; ensuring compliance with American with Disabilities Act and requirements for reasonable accommodations; ensuring proper financial allocation of expenditures and revenues; managing and implementing comprehensive employee benefits programs, including group medical, dental, vision, life insurance, Section 125, and other employee benefits programs; acquiring and/or providing varied and highly complex assistance and information to senior District management.
Essential Job Functions:
Acts as property and liability insurance liaison with community, school staff, and business/governmental entities
Administers property and liability claims against the District, including litigation case management
Administers the employee training through Target Solutions
Administers employee and retiree eligibility provisions for District group insurance plans; oversees the annual open enrollment process for all District employees and eligible retirees
Administers programs to promote safe working conditions and reduce loss experience
Analyzes complex problems to formulate effective solutions
Analyzes, classifies, and rates risks, exposure, and loss expectancies
Analyzes documents (e.g. student accident and employee injury reports, doctors’ reports, vocational rehab analyses, permanent disability rating, etc.) to determine appropriate course of action and/or recommendation for proper handling of claim and workers’ compensation settlement
Analyzes claims and uses judgment and tact in recommending or exercising appropriate action
Answers questions, handles complaints, and prepares claims
Assesses and evaluates the District’s exposure to risk; recommends, implements, and monitors risk avoidance, risk transfer, risk sharing, and risk financing options for the District’s workers’ compensation, property, casualty and general liability programs, employee and student safety, and other exposures through appropriate prevention and loss control programs
Communicates with retirees regarding premiums, benefits, age limitations, or continued participation, and coordination of benefits with Medicare and related matters
Compiles and maintains special confidential correspondence and administrative files of correspondence and other documents
Compiles data to obtain insurance coverage regarding general liability, property, certificates of insurance, field trips, and student clubs/activities
Composes documents (e.g. correspondence, agendas, minutes, reports, etc.) to communicate information to school district personnel, Board members, parents, state officials and agencies, legal counsel, and insurance administrators
Conducts ergonomic assessments
Coordinates Disaster Committee plans, drills, and training
Coordinates aspects of litigation claims filed against the District; serves as District representative at court proceedings, reviews and prepares discovery documents to assist legal counsel, and coordinates attendance of District employees at court proceedings
Coordinates light duty/return to work programs for injured/ill district employees; consults with physicians on specific employees’ injuries and special accommodations
Develops benefit plan communication materials for participants
Evaluates situations, concerns, complaints, etc. to diffuse potentially hazardous interactions and/or requests assistance and intervention, if required
Evaluates, trains, and assigns the employee benefits staff
Identifies physical and/or psychological job restrictions/limitations and recommends job-related accommodations; consults with District staff to help facilitate timely return to work of injured employees
Identifies and evaluates unsafe work place conditions and unsafe work practices to recommend changes and solutions to employees and management
Implements, supervises, and directs day-to-day technical details and assists in the planning of employee benefit programs (e.g. group medical, dental, vision, life long-term disability insurance programs, Section 125 and cafeteria benefits, and other programs as assigned) for active certificated and classified employees, retirees, and eligible dependents
Interprets insurance contract language, makes eligibility determinations, and disseminates to employee benefits staff for implementation
Interprets and explains laws, rules, policies, and agreements to District officials, employee organizations, and the public
Investigates and reviews authenticity of claims; determines appropriateness and feasibility of subrogation, and follows up on procedures
Maintains liaison with administrators, employee groups, insurance carriers, rehabilitation counselors, attorneys, government agencies, and others to obtain important and/or confidential information relating to claims and loss control functions
Manages, implements, and oversees the online benefits enrollment system
Manages District compliance with ADA (Americans with Disabilities Act) requirements related to job restructuring, work scheduling, and requests for reasonable accommodations
Manages all appeals cases from participants, beneficiaries, legal representatives, and employee organizations
Manages administration of student accident insurance
Monitors activities and/or components to ensure compliance with established financial, legal, and/or administrative requirements
Negotiates contracts and rates for insurance carriers and contracts; serves as liaison with collective bargaining unit representatives to develop, coordinate, and implement modifications to employees’ benefits plans
Orients new personnel to ensure their understanding of established policies and procedures
Oversees employees on modified duty to provide support and ensure coordination of production and work restrictions with supervisors and physicians
Participates in informational activities (e.g. meetings, workshops, health fairs, etc.) to receive and/or provide information
Participates in highly confidential employee management and/or Governing Board meetings and deliberations
Prepares a variety of program and project materials, including correspondence, bulletins, handbooks, newsletters, documents, and exhibits,
Presents information on administrative procedures, services, regulations, etc. to train and orient other personnel
Processes various reports to update information and/or ensure coverage of employees
Provides updates to District website regarding benefits and risk management
Provides technical expertise, counsel, and recommendations to District administrators, bargaining units, vendors, or employees in risk management, safety, or insurance areas
Receives complaints, relays information, and makes referrals as necessary
Recommends the selection of staff, evaluates staff, and imposes disciplinary action when necessary
Reports, schedules, and oversees the removal of asbestos
Represents the District at the Workers’ Compensation Appeals Board, Civil Court, JPA Boards, and depositions
Researches various information (e.g. current practices, policies, Education Code, Labor Code, etc.) to provide recommendations and/or to address a variety of administrative requirements
Researches and reviews principles, trends, methods, and procedures pertaining to modem employee benefits administration
Resolves disputes and communicates with participants in cases that cannot be routinely handled by employee benefits representatives
Reviews and maintains student accident reports to assist in investigations and/or recommendations for safe school environments
Reviews claims and investigates as required, advising claimant of policy provision and claims procedures; prepares necessary documentation; works closely with claims administrators and brokers in determination of claimant eligibility and propriety of disputed claims
Serves as liaison between employees, carriers, and health care providers, arranging presentations to employee groups to assure their understanding of benefit programs and coordinating in-services
Supervises the processing and maintenance of records involving legal actions, liability claims, property damage, personnel and student accidents/injuries, vandalism reimbursements, and vehicle accidents
Supervises the handling and removal of hazardous materials
Supports Director of Fiscal Services and Assistant Superintendent of Business Services, as well as the Director and Assistant Superintendent of Personnel Services to provide assistance with administrative functions
Travels roads on inclement weather days to ensure safe passage for student transportation
Other Job Functions:
Assists other personnel for the purpose of supporting them in the completion of their work activities
Job Requirements - Qualifications:
Knowledge of:
Risk management administration and procedures
State and federal laws relating to workers’ compensation and liability
Principles of supervision and management
Research, analysis, data management, storage, and retrieval
Insurance underwriting
Benefits, cost projections, risk analysis, and loss control principles and practices
Labor, safety, and environmental laws and codes
Public relations principles
Safety practices
Oral communication skills
Computer and software literacy
Record-keeping techniques
Basic math, plus algebra and geometry, for practical applications
Standard office equipment
Standard clerical and bookkeeping/accounting procedures
Pertinent software applications
Ability to:
Demonstrate tact, discretion, and diplomacy in dealing with sensitive situations and concerned people and customers
Listen, with empathy, to concerns of employees, managers, and others affected by risk management activities
Establish and maintain effective working relationships with District managers and administrators, representatives of other governmental agencies, insurers, vendors, third-party administrators, employers, and others encountered in the course of work
Interpret, apply, and explain laws, rules, regulations, policies, procedures, and contracts pertaining to risk management, safety, and legal procedures
Perform multiple specialized technical tasks
Communicate clearly, both orally and in writing
Schedule diversified loss prevention and safety programs
Plan and manage projects
Prepare and maintain accurate records
Prepare budgets and financial plans
Process data
Coordinate others’ schedules and/or activities
Interact with persons and/or agendas that frequently change
Meet deadlines and schedules and work under time constraints
Motivate, train, supervise, and evaluate the performance of assigned staff
Analyze situations to define issues and draw conclusions
Utilize pertinent software applications
Responsibility includes leading, guiding, and/or coordinating. This position supervises the use of funds with responsibility for the care of assets. The resources required (people, equipment, facilities, and/or funding) to perform job functions are of a significant scope, and frequent opportunity exists for significant impact (positive or negative) on the organization’s mission. Work is not normally reviewed in detail.
Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The job functions are generally performed in an indoor environment requiring the following significant physical abilities: reaching, handling, fingering and/or feeling, sensory speaking, hearing, and visual.