Program Management
• Develop, implement, and maintain comprehensive underwriting policies and procedures
• Rate new business and renewals, establish x-mod, credit/debits for member contributions
• Manage and coordinate the actuarial process with third-party actuaries
• Oversee claims management process from initial reporting through resolution
• Manage relationships with insurance carriers, third-party administrators, and vendors
• Monitor program performance metrics and prepare regular reports for leadership
• Manage compliance and reporting to DIR and OSIP
Claims Administration
• Coordinate with the third-party administrator (TPA) to ensure claims are examined and managed efficiently with attention to:
o Investigation of claims for accuracy and validity
o Coordinate with medical providers, legal counsel, and rehabilitation specialists
o Manage return-to-work programs and light-duty assignments
o Negotiate claim settlements and dispute resolution when appropriate
o Maintain detailed documentation and case files
Risk Management & Safety
• Review workplace safety assessments and risk evaluations
• Manage and deliver safety training programs for member organizations
• Recommend and implement injury prevention strategies and safety protocols
• Analyze loss trends and recommend corrective actions
• Collaborate with member nonprofits to improve workplace safety cultures
Stakeholder Relations
• Serve as primary point of contact for member organizations and brokers on workers’ compensation matters
• Provide technical assistance and guidance to nonprofit staff and leadership
• Facilitate communication between all parties involved in claims processes
• Present reports at Governing Board meetings