- Serves as resource for EMC's workers' compensation policyholder programs.
- Markets and implements EMC's workers' compensation programs to agents and policyholders.
- Guides policyholders through the process of developing formal workers' compensation programs.
- Consults with the policyholder on effective work comp programs, such as OnCall Nurse (Nurse Triage), Pre-Work Screenings, Return to Work, Select Provider, and Wellness by guiding them through the process and creating resources for workers recovering from workplace injuries.
- Tailors the program to each policyholder's specific needs, advising of best practices for implementation and program management based on policyholder specific features.
- Implements and communicates the appropriate program based on policyholder's location(s) and need(s).
- Advises EMC offices, agents, policyholders, and other business units of implementations and changes made to workers' compensation programs.
- Analyzes policy coverage and communicates with internal business units regarding program notices related to policy cancellations and/or changes.
- Presents educational information regarding EMC's workers' compensation programs and outcomes for internal or external meetings.
- Conducts internal and external trainings for EMC offices, agents, and insureds and follows up regarding program interest, implementation, and/or usage.
- Researches and develops the workers' compensation program database for policyholders upon
- Researches and develops the workers' compensation program database for policyholders upon program initiation.
- Guides policyholders on key points in developing post-offer prework screening programs and in choosing medical providers as part of the workers' compensation programs that are affiliated with Preferred Provider Networks (PPO), when available.
- ]Advises on the provider specialties to utilize for workers' compensation injuries.
- Conducts PPO and analytical review of higher performing providers and bases recommendations to policyholders on those analyses.
- Validates provider upload to the nurse triage partner ensuring seamless implementation/usage.
- Coaches policyholders on the importance of feedback regarding the providers in their programs.
- Collects, enters, and manages data in all systems from implementation to policy or program cancellation.
- Develops physician panels and posters in accordance with state guidelines for various EMC policyholders or upon request from agents.
- Communicates with agents and policyholders to educate and implement the physician panel/poster within the policyholder's workplace.
- Monitors panels and posters as to ensure provider accuracy of the provider information
- Conducts on-site or virtual job analysis as requested by policyholders and documents observations, including types of personal protective equipment and tools, exertion and functional levels, workplace environment, job hazards, skills, and abilities.
- Guides policyholders through the process of validating new job descriptions by analyzing questionnaires, conducting interviews, reviewing drafts, and finalizing the descriptions after discussions and negotiations with all parties.
- Communicates with underwriters, claims, and agents about services that EMC policyholders have requested and determines level of policyholder service and/ or communications involvement.
- Educates EMC claims, underwriting, marketing, and loss control team members on the benefits of injury management services.
- Bachelor's degree preferably in business, marketing, or health and safety related field, or equivalent relevant experience
- Five years of experience in workers' compensation, claims, or a health or safety-related field, or related experience
- Attainment of all applicable state licenses within six months of hire
- Relevant insurance designations preferred
- Experience with nurse triage, return to work, and/or prework screening programs preferred
- Strong understanding and ability to identify physical demands of a full range of jobs
- Working knowledge of functional job analysis, Americans with Disabilities Act, employment regulations, and state workers' compensation laws
- Good understanding of workers' compensation insurance and jurisdictional rules
- Knowledge of business management, insurance, claims systems and safety standards
- Strong written and verbal communication skills, including presentation and negotiation skills
- Good interpersonal and customer service skills
- Ability to effectively manage multiple priorities, changing deadlines and frequent interruptions
- Good organizational and analytical abilities
- Good computer skills, including Microsoft Office Suite
- Occasional travel required; a valid driver's license with an acceptable motor vehicle report per company standards required if driving
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Workers' Compensation Programs Specialist - Des Moines, United States - EMC Insurance
Description
At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees.
**This position is eligible to work from home anywhere in the United States** Essential Functions:
Education & Experience:
Knowledge, Skills & Abilities:
**Per the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $74, $95, The hiring range for other locations may vary.**
Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.
All of our locations are tobacco free including in company vehicles.
