This position is a remote/field position. Travel is required.
Must resides within the U.S. and able to work EST/CST work hours.
SUMMARY:
Responsible for managing and coordinating the investigation processes to serve enterprise/brand Investigative Services business. This responsibility includes; serving as the technical expert for causation specialists, leading team members and managing resources to achieve team goals and objectives supporting enterprise and corporate claims business goals. Sets annual unit business goals, monitors production, business activity, and develops metric reports ensures business process timelines are met. Establishes roles and responsibilities while maximizing use of employee talent. Assists and monitors workloads, acts as liaison between the department and other claims functions, establish team goals, procedures, and strategies. Manages and assists with coordination of external vendors. Assists with validation of investigation results through compensability decisions. This position will still perform causation analysis, and supports a field case load. Supports ISU Director as required and directed.
RESPONSIBILITIES/TASKS:
- Primarily manages technical exempt and general non-exempt staff members.
- Responsible for reviewing the work produced by team members.
- Conducts a reasonable field caseload as performed by Sr. Causation Specialist
- Assess various machinery and operations in evaluating and establishing negligence and 3rd party liability for subrogation process.
- Partnering with assigned claims professional, responsible for assessing client’s industrial hygiene, including equipment maintenance and calibrations, pre-survey studies and research, completion of technical field evaluations and final reports.
- Evaluate employees to ensure the best utilization of unit talent and conducts required performance evaluations.
- Communicate and collaborate with all of the various enterprise/brand departments/teams.
- Lead the development of Causation team goals, objectives, processes, procedures, and systems.
- Participates and as requested leads with annual departmental budget, monitors budget and identifies budget discrepancies. Researches the causes and makes recommendations.
- Identifies team-staffing needs and takes necessary measures to ensure appropriate levels of service.
- Consistently monitors workflows to maximize efficiency.
- Maintains an acceptable level of service and customer satisfaction and retention.
- Evaluate training needs, develops training plans and ensures implementation.
- Ensure efficient and effective use of company resources, evaluates processes and procedures, and develop new procedures.
- Apply up-to-date technical knowledge of Causation investigation analysis process.
- Ensures maximum team effectiveness through coordination of team functions/activities and streamlining processes to minimize duplication of efforts and promote team efficiency.
- Mentor employees and growth opportunities for team.
- Provide guidance and advice when required or necessary and encourage/motivate employees in their daily efforts.
- Participate in ISU programs as a strategic partner that supports the Company plan.
- Represent company in community and industry, programs and conferences.
- Support technical knowledge and expertise in the causation investigation program.
- Conduct thorough peer reviews of reports to ensure accuracy, consistency, and adherence to organizational standards, providing constructive feedback to enhance the quality of deliverables.
- Maintain confidentiality.
Supervisory: Directly manages exempt and non-exempt staff. Assists with managing the department in the Directors absence. Carries out responsibilities in accordance with company policies and applicable laws. Responsibilities include interviewing, selecting and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints; and resolving problems.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS:
EDUCATION:
Bachelor’s degree in business, criminal justice, law enforcement, insurance, occupational safety and health, ergonomics, or related field of education. Knowledge of insurance fraud and other relevant civil and criminal laws is preferred. Extensive experience in Occupational Health, Workers Compensation Case Management, Ergonomics, Safety or other related subject required. Continuous learning required, as defined by the Company’s learning philosophy. Certification, or progress toward, highly preferred and encouraged.
EXPERIENCE:
Ten years of progressive responsibility in safety or causation analysis or a claims investigation environment with demonstrated technical knowledge which provide the necessary skills, knowledge and abilities. Three years demonstrated leadership in causation or claims required. Workers Compensation insurance administration experience preferred.
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
- Strong knowledge of laws, regulations, and compliance requirements related to insurance.
- Demonstrated technical knowledge of insurance administration, claims management, or relevant insurance expertise.
- Knowledge of insurance and underwriting techniques, agency and policyholder needs.
- Demonstrated expertise in using Excel to create detailed monthly and quarterly reports for claims staff, causation staff, and other enterprise business partners, ensuring accuracy and clarity in data presentation and analysis.
- Foster a supportive and inclusive work environment by prioritizing the well-being and development of team members, encouraging open communication, and promoting a culture of collaboration and respect.
- Ability to understand ergonomic and forensic job analysis.
- Knowledge of team-building and employee motivation theories with the ability to effectively manage multi-functional employee teams.
- Ability to work with and empower others on a collaborative basis to ensure success of unit team.
- Excellent oral and written communication skills.
- Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions and employing active listening techniques.
- Communicates and collaborates with all brands - claim teams.
- Ability to effectively present budgetary and/or cost information, and respond to questions as appropriate.
- Ability to establish workflows, manage multiple projects, and meets necessary deadlines.
- Ability to maintain confidentiality.
- Ability and proficiency in the use of computers and company standard software specific to position.
- Ability to perform other assignments at locations outside the office.
- Ability to use video production and editing software.
WORKING CONDITIONS:
Work is performed in an office/remote setting with no unusual hazards. Travel is required with occasional overnight stays. Must possess a valid driver’s license with a record that meets corporate standards.
The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.
Pay Range “Actual compensation decision relies on the consideration of internal equity, candidate’s skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $92,200 and $154,500.”
We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.