Overview
Be inspired. Be rewarded. Belong. At Emory Healthcare.
At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Family-focused benefits
- Wellness incentives
- Ongoing mentorship development and leadership programs
- And more
Description
Job Summary The Workers Compensation Manager is responsible for the strategic and operational oversight of the Workers Compensation programs for Emory Healthcare and Emory University. This role provides subject matter expertise in the management of medico-legal claims regulatory compliance and case management operations to ensure high-quality cost-effective outcomes for injured employees. The position partners closely with internal and external stakeholders to promote injury prevention timely return-to-work and continuous program improvement while ensuring adherence to State Board of Workers Compensation and OSHA requirements. Key Duties and Responsibilities Program Leadership & Strategy 1. Lead and manage the Workers Compensation programs for Emory Healthcare and Emory University ensuring alignment with organizational objectives and regulatory requirements. 2. Provide subject matter expertise on the strategic management of medico-legal claims and complex case scenarios. 3. Assess implement and monitor program options and services to meet employee health needs while promoting quality and cost-effective outcomes. 4. Develop implement and evaluate collaborative clinical pathways and case management models to enhance program efficiency and effectiveness. 5. Partner with senior leaders and stakeholders to identify opportunities for continuous improvement and risk mitigation. Claims Management & Return-to-Work 1. Oversee case management for prolonged complex or litigated workers compensation claims to facilitate appropriate care and timely return-to-work. 2. Partner with supervisors and department leaders to identify implement and promote return-to-work strategies aligned with State Board of Workers Compensation and industry best practices. 3. Coordinate care and services with nurse case managers advanced practice providers third-party administrators and external healthcare providers. 4. Monitor claim progression and outcomes to ensure adherence to clinical legal and operational standards. 5. Support accident investigations through root cause analysis and implementation of corrective actions to prevent recurrence. Regulatory Compliance & Risk Management 1. Serve as the primary point of contact for State Board of Workers Compensation communications including stipulations notices and reporting requirements. 2. Collaborate with Environmental Health and Safety (EHSO) and Quality teams on OSHA log reconciliation posting and compliance activities. 3. Review and maintain compliance with state and federal workers compensation laws OSHA regulations and internal policies. 4. Conduct annual reviews of the Panel of Providers and make recommendations to ensure regulatory compliance and operational alignment. 5. Facilitate periodic meetings with Panel Providers to ensure adherence to reporting documentation and process requirements. Vendor & Financial Oversight 1. Manage third-party vendor relationships including TPAs PBMs legal partners and field case management services ensuring service level agreements and performance guarantees are met. 2. Review interpret and analyze metrics and reports provided by business partners including monthly expenditure and utilization reports. 3. Share performance trend and budget data with the Director and applicable internal stakeholders to support informed decision-making. 4. Monitor program expenditures to ensure adherence to approved budgets and financial targets. 5. Identify opportunities to improve vendor performance cost containment and service quality. People Leadership & Collaboration 1. Supervise mentor and develop nurse case managers workers compensation professionals and advanced practice providers. 2. Develop implement and evaluate staff performance using defined key performance indicators and competency standards. 3. Manage day-to-day staffing operations including training hiring performance evaluations and quality improvement initiatives. 4. Collaborate with Human Resources Operations EHSO and other partners to design and implement programs supporting injury prevention and employee health. 5. Contribute expertise to the development of controls and surveillance strategies addressing actual and potential workplace hazards. Additional Duties as Assigned Travel: Between Operating Units May be Required Work Type: Hybrid Employee REQUIRED
MINIMUM QUALIFICATIONS: Education: Bachelors degree in nursing from an accredited school of nursing. License: Active unincumbered RN license from the State of Georgia or an active and unencumbered RN license that meets eligibility requirements to practice in the State of Georgia. Experience: Five (5) years of occupational health experience including two (2) years of healthcare leadership experience or ten (10) years of clinical nursing experience. Certification: Certified Occupational Health Nurse designation (COHN) upon hire or obtain designation within 3 years of hire. Knowledge Skills and Abilities: 1. Current knowledge of laws and regulations governing worker and worksite health and safety including OSHA workers compensation ADA & FMLA. 2. Proficient knowledge of the regulations set by the Georgia State Board of Workers Compensation. Preferred qualifications: Education: MSN or MPH degree. Experience: Medico-Legal Experience related to workers compensation and claims management. Occupational Health experience in healthcare setting. REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs 34-66% of the workday (frequently); 01-10 lbs 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking Occasional sitting Close eye work (computers typing reading writing) Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste. Chemicals/gases/fumes/vapors Communicable diseases Electrical shock Floor Surfaces Hot/Cold Temperatures Indoor/Outdoor conditions Latex Lighting Patient care/handling injuries Radiation Shift work Travel may be required. Use of personal protective equipment including respirators environmental conditions may vary depending on assigned work area and work tasks.
Required Experience:
Senior Manager
OverviewBe inspired. Be rewarded. Belong. At Emory Healthcare.At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your care...
Overview
Be inspired. Be rewarded. Belong. At Emory Healthcare.
At Emory Healthcare we fuel your professional journey with better benefits valuable resources ongoing mentorship and leadership programs for all types of jobs and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide:
- Comprehensive health benefits that start day 1
- Student Loan Repayment Assistance & Reimbursement Programs
- Family-focused benefits
- Wellness incentives
- Ongoing mentorship development and leadership programs
- And more
Description
Job Summary The Workers Compensation Manager is responsible for the strategic and operational oversight of the Workers Compensation programs for Emory Healthcare and Emory University. This role provides subject matter expertise in the management of medico-legal claims regulatory compliance and case management operations to ensure high-quality cost-effective outcomes for injured employees. The position partners closely with internal and external stakeholders to promote injury prevention timely return-to-work and continuous program improvement while ensuring adherence to State Board of Workers Compensation and OSHA requirements. Key Duties and Responsibilities Program Leadership & Strategy 1. Lead and manage the Workers Compensation programs for Emory Healthcare and Emory University ensuring alignment with organizational objectives and regulatory requirements. 2. Provide subject matter expertise on the strategic management of medico-legal claims and complex case scenarios. 3. Assess implement and monitor program options and services to meet employee health needs while promoting quality and cost-effective outcomes. 4. Develop implement and evaluate collaborative clinical pathways and case management models to enhance program efficiency and effectiveness. 5. Partner with senior leaders and stakeholders to identify opportunities for continuous improvement and risk mitigation. Claims Management & Return-to-Work 1. Oversee case management for prolonged complex or litigated workers compensation claims to facilitate appropriate care and timely return-to-work. 2. Partner with supervisors and department leaders to identify implement and promote return-to-work strategies aligned with State Board of Workers Compensation and industry best practices. 3. Coordinate care and services with nurse case managers advanced practice providers third-party administrators and external healthcare providers. 4. Monitor claim progression and outcomes to ensure adherence to clinical legal and operational standards. 5. Support accident investigations through root cause analysis and implementation of corrective actions to prevent recurrence. Regulatory Compliance & Risk Management 1. Serve as the primary point of contact for State Board of Workers Compensation communications including stipulations notices and reporting requirements. 2. Collaborate with Environmental Health and Safety (EHSO) and Quality teams on OSHA log reconciliation posting and compliance activities. 3. Review and maintain compliance with state and federal workers compensation laws OSHA regulations and internal policies. 4. Conduct annual reviews of the Panel of Providers and make recommendations to ensure regulatory compliance and operational alignment. 5. Facilitate periodic meetings with Panel Providers to ensure adherence to reporting documentation and process requirements. Vendor & Financial Oversight 1. Manage third-party vendor relationships including TPAs PBMs legal partners and field case management services ensuring service level agreements and performance guarantees are met. 2. Review interpret and analyze metrics and reports provided by business partners including monthly expenditure and utilization reports. 3. Share performance trend and budget data with the Director and applicable internal stakeholders to support informed decision-making. 4. Monitor program expenditures to ensure adherence to approved budgets and financial targets. 5. Identify opportunities to improve vendor performance cost containment and service quality. People Leadership & Collaboration 1. Supervise mentor and develop nurse case managers workers compensation professionals and advanced practice providers. 2. Develop implement and evaluate staff performance using defined key performance indicators and competency standards. 3. Manage day-to-day staffing operations including training hiring performance evaluations and quality improvement initiatives. 4. Collaborate with Human Resources Operations EHSO and other partners to design and implement programs supporting injury prevention and employee health. 5. Contribute expertise to the development of controls and surveillance strategies addressing actual and potential workplace hazards. Additional Duties as Assigned Travel: Between Operating Units May be Required Work Type: Hybrid Employee REQUIRED
MINIMUM QUALIFICATIONS: Education: Bachelors degree in nursing from an accredited school of nursing. License: Active unincumbered RN license from the State of Georgia or an active and unencumbered RN license that meets eligibility requirements to practice in the State of Georgia. Experience: Five (5) years of occupational health experience including two (2) years of healthcare leadership experience or ten (10) years of clinical nursing experience. Certification: Certified Occupational Health Nurse designation (COHN) upon hire or obtain designation within 3 years of hire. Knowledge Skills and Abilities: 1. Current knowledge of laws and regulations governing worker and worksite health and safety including OSHA workers compensation ADA & FMLA. 2. Proficient knowledge of the regulations set by the Georgia State Board of Workers Compensation. Preferred qualifications: Education: MSN or MPH degree. Experience: Medico-Legal Experience related to workers compensation and claims management. Occupational Health experience in healthcare setting. REQUIREMENTS (Medium): 20-50 lbs; 0-33% of the work day (occasionally); 11-25 lbs 34-66% of the workday (frequently); 01-10 lbs 67-100% of the workday (constantly); Lifting 50 lbs max; Carrying of objects up to 25 lbs; Occasional to frequent standing & walking Occasional sitting Close eye work (computers typing reading writing) Physical demands may vary depending on assigned work area and work tasks.
ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste. Chemicals/gases/fumes/vapors Communicable diseases Electrical shock Floor Surfaces Hot/Cold Temperatures Indoor/Outdoor conditions Latex Lighting Patient care/handling injuries Radiation Shift work Travel may be required. Use of personal protective equipment including respirators environmental conditions may vary depending on assigned work area and work tasks.
Required Experience:
Senior Manager
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