Purpose: The Senior Risk Management Analyst is responsible for providing oversight to the company's Workers' Compensation claims in the US and Canada, ensuring timely and appropriate resolution through appropriate compensability determination, reserving, and settlement evaluation. This position acts as a liaison between Third-Party Administrators (TPAs) and Field Operations.
Essential Functions:
Guides field management on ensuring accurate claim reporting, claim management and return-to-work procedures; provides field training on various aspects of safety and Workers Compensation compliance
Monitors TPA expenses regarding assignment of outside claim investigators, nurse case management, physician reviews, Medicare/SCHIP Set-Asides
Coordinates complex claim resolution with Legal, including claims that have an ADA, EEOC or FMLA component to the Worker's Compensation claim
Provides oversight of third-party administrator by conducting quarterly claim reviews, audits, and other claim related projects
Provides and manages oversight of the Company National Occupational Medial vendor
Manages State Funded Workers' Compensation oversight regarding uploads to claim system, quarterly premium payments, and outside attorney assignment and expenses
Identifies claim trends and recommends training programs, procedures, and actions to reduce claim costs
Develops and maintains state required in-network physician panels
Monitors 24/7 Nurse Triage program and encourages location participation
Updates knowledge base on claim practices, case law, and industry claim trends
Processes premium payment in US and Canada
Handles OSHA complaints, investigations and formal response
Manages and oversees safety audit for compliance
Manages and oversee the Company Slip Resistant program
Reporting Relationship: The Senior Risk Management Analyst reports to the Senior Director of Risk Management.
Minimum Qualifications, Knowledge, Skills, and Work Environment:
Education and Experience: The combination of education and professional experience must exceed 3 years:
In a technical role: Requires 3-5 years of technical claims experience with a carrier or TPA
A bachelor's degree in a program related to the functional area can count for 1 of the 3-year requirement
Preferred experience working in Risk Management in the Food & Beverage, Retail, or Hospitality industry and across multiple locations
Specialized Training:
Training that leads to federal and state-specific Workers' Compensation regulations
Training that leads to strong understanding of technical claims procedures, medical protocols, and best practices
Specialized Skillset/Competencies/Traits
Proficient in Microsoft Office and Claim Management Systems
Requires the ability to use discretion and uphold a high level of confidentiality
Business acumen and also has the mindset required to understand the long-term implications of risk management planning and to advance the organizations goals
Demonstrated history of understanding the needs of the business, stakeholders, the employee population and individual circumstances
Demonstrated history of creating and maintaining positive work environments
Location: This position is based at the F&B Center of Excellence in Bethesda, MD