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Develops and maintains internal relationships (accounting, legal, pharmacy) and external relationships (wholesalers, manufacturers, contract pharmacies, pharmacy benefits managers (PBMs), and third-party administrator (TPA) vendors) as needed.
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The Safety Data Analyst-Reporting to the Corporate Safety Manager, this position will work closely Risk Management, Legal, and other internal stakeholders. The Safety Data Analyst will use data for analysis and actionable insights that drive the success of the initiatives and projects associated with Safety & Risk. The Data Analyst will work closely with key stakeholders (e.g., Drive Shield Core Team, Safety, Fleet, Legal, Human Resources, Risk Management, Supply Chain and Commercial/Sales teams) to provide the analytics to craft strategies and design solutions to mitigate safety/risk/operational areas.
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Must be able to deal effectively with all levels of employees, management, outside benefits professionals (insurance contacts, TPA, actuaries), legal counsel and regulatory agencies. Evaluating, selecting and directing benefits consultants, actuaries, brokers, and necessary legal counsel.
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Attend and participate in quarterly claims review meetings with the Risk Manager, TPA and Legal Counsel providing thoughtful and valuable claim recommendations for resolving claims. Serve as liaison with the Workers Compensation third party administrator (TPA), ensuring quality delivery of services, accurate and timely claim administration, and effective cost management.
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Works in partnership with the legal department on any pending litigation and coordinates with Third Party Administrators (TPA). Tracks music licensing requirements and provides reporting as needed.
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Reviews and communicates with third-party administrators (TPA); oversees TPA handling of worker's compensation and liability claims against the City; and consults with management and legal counsel to determine proper actions regarding worker's compensation and tort claims.
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Handle General Liability / Bodily Injury, Property, Commercial Auto Liability and/or Physical Damage, Workers Compensation, Inland Marine, Professional / Management Liability, Business Interruption, Liquor Liability, Garage/Garagekeepers Legal Liability or Umbrella claims.
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Daily management of workers' compensation claims portfolio, in concert with TPA. Manage relationship with internal and external stakeholders, including Litigation, Legal, HR, Operations, Procurement, Safety, Finance, Third Party Administrators, Brokers, Insurers, etc.
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Determine when vendor involvement may be necessary, such as medical case management, vocational rehabilitation counseling, legal, surveillance, Independent Medical Examiner (IME), Independent Adjuster (IA), etc., and discuss with Claims Manager.
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Maintain relationships with the Trust, Third Party Administrator (TPA) and legal counsel to resolve open claims. The Director of Risk Management & Compliance is a key role within the CFO's office and Finance Department, with responsibility for enterprise risk management, insurance/workers' compensation, contracts and assistance with legal affairs for Roberts Wesleyan University.
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Claims Management – manage claims for assigned insurance programs and work closely with in-house litigation counsel, claim consultants, and TPA on efficient resolution strategies. Person in this position will work closely with members of Finance, Legal, Environmental Health & Safety, Procurement, Human Resources, Real Estate & Facilities, Logistics, Security and others in the development and communication of programs and initiatives aimed at mitigating risk of loss, while minimizing long-term total cost of risk for the organization.
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Works directly with the County Civil/Legal Office and the excess insurance carrier to develop a strategic plan of action to handle liability claims in litigation. Oversees the worker's compensation program, including the processing of claims by assigned staff and the third-party administrator (TPA.
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Quarterbacks all post bind activities including policy production, compliance issues, audits and adjustments, legal agreements, receipt of collateral, legal agreement execution, TPA coordination and any other related items.
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Possess a cross-functional generalist knowledge of other disciplines including claims, risk control, audit, premium accounting, finance and legal. Possess a thorough understanding of all loss sensitive programs including products, pricing, expensing, actuarial loss projecting techniques, retention and aggregate setting, limit profiles, ALAE, and effective utilization of facultative reinsurance.
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Hiring for Engineering, Finance and Accounting, Healthcare, Human Resources, IT, Legal, Life Sciences, Manufacturing and Logistics, Sales and Marketing and Administrative roles. Process a variety of Third Party Administrator (TPA) payments.
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