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Stanford Health Care · 1 month ago

Claims Manager - Workers Compensation

Sacramento, CA

Full-time

Onsite

Senior Level

$66.52/hr - $88.14/hr

5+ years exp

Stanford Health Care is committed to innovation and providing exceptional patient care. The Claims Manager oversees the workers' compensation claims program, ensuring efficient claims handling and collaboration with internal partners to reduce work-related injuries.

Health CareHealth DiagnosticsHospitalMedicalPrimary and Urgent Care

Comp. & Benefits

Responsibilities

Responsible for oversight of all TPA activities to ensure efficient and cost-effective claims handling in accordance with hospital policies and procedures and the applicable service agreement. Review reserves, settlement activity, and claims costs. Participate in periodic claim reviews and provide substantive input regarding claim strategy

Participate in negotiation of TPA contracts

Serve as liaison with external departments, including Human Resources, Workforce Health and Wellness, and Environmental Health & Safety to coordinate issues impacting claim resolution and injury/illness prevention. Participate in periodic committee meetings as warranted. Provide training related to claims workflow and processes

Responsible for collection and analysis of claims data. Create reports and disseminate claims data to stakeholders. Evaluate trends to support loss prevention

Ensure timely and accurate processing of all claim invoices

Qualification

Claims Practitioner certificationData analysisWorkers' Compensation knowledgeRegulatory knowledgeComputer systems knowledgeCommunication skillsProblem-solving skillsTeam leadership