Administers a multifaceted workers’ compensation program, including workers compensation operations, loss control, return to work, investigations, training, reporting and continuous strategic improvement efforts. Participates in workplace surveys, educational presentations, environmental monitoring and industrial safety activities designed to reduce work-related injuries and illnesses. Embodies the Memorial Health Values of Safety, Integrity, Quality, and Stewardship that support our mission and vision.
QualificationsEducation:
Bachelor’s Degree in healthcare, human resources, business, or related field required.CMA, LPN or RN also accepted.Licensure/Certification/Registry:
Licensed as LPN or RN in State of Illinois if applicable.
Experience:
Minimum two years’ previous case management, healthcare, or related experience required.Workers’ Compensation knowledge and experience preferred.
Other Knowledge/Skills/Abilities:
Excellent computer skills, including all Microsoft products (Word, Excel, Power Point, Outlook) .Ability to demonstrate exceptional skills in all forms of communication.Excellent organizational skills, strong attention to detail and ability to maintain confidentiality.Ability to work autonomously on several projects concurrently. Responsibilities Coordinates the detailed investigation of workers’ compensation claims for all MH affiliate colleagues covered under the Illinois Risk Management Services or Illinois Compensation Trust.2. Gathers and analyzes data and develops and maintains current and accurate reports regarding expenses and workers compensation injuries and reserves. Participates in gathering and presenting statistical data and recommendations to the Ergonomics Committee, Environment of Care, Finance, excess insurance carrier, actuarial audits, legal reviews and individual departments.
3. Embodies the Memorial Health’s Performance Excellence Standards of Safety, Courtesy, Quality, and Efficiency that support our mission, vision and values:
SAFETY: Prevent Harm - I put safety first in everything I do. I take action to ensure the safety of others.COURTESY: Serve Others - I treat others with dignity and respect. I project a professional image and positive attitude.
QUALITY: Improve Outcomes - I continually advance my knowledge, skills and performance. I work with others to achieve superior results.
EFFICIENCY: Reduce Waste - I use time and resources wisely. I prevent defects and delays.
Through a process of case management, acts as a liaison with nursing, physician, and therapy staff to facilitate problem solving and coordination of services, enhancing the efficiency and effectiveness of individualized treatment plans that promote early recovery and return to work. Coordinates care for Occupational Health Clinic/Visits. Schedules follow-up treatment and initiates referral process when indicated.
Utilizes effective communication to interact with colleagues , leaders and multi-disciplinary team members to facilitate colleague’s participation in treatment and discharge plan. Guides leaders on workers compensation process which includes, but is not limited to light duty accommodations, coding, PCR and leaves of absence.
Assists HR leadership in monitoring effectiveness and efficiency of the Workers’ Compensation Program, participating in plans to facilitate program development in line with organization and department objectives.
Stays current with new developments in the field of rehabilitation, Ergonomics, Workers Compensation law, FMLA, ADA, HIPAA and best practices.
In coordination with Risk Management, Environment of Care & Ergonomics committees, and Safety departments, develops injury prevention strategies, promotes and deploys accident and injury prevention initiatives. Develops educational materials for leaders and colleagues and presents topics related to Workers’ Compensation as requested by individual departments and for purposes of organization-wide training.
In conjunction with IRMS, ICT and outside legal, reviews all legal cases, closure of pro settlement agreements as directed, and in consultation with leadership, makes recommendations for settlement of cases. Prepares case summaries and attends arbitration sessions as required.
Coordinates all aspects of the Return to Work (RTW) program for work injured colleagues, including communication to individual colleagues , managers, departments, tracking of restricted workdays, appropriate cost center accounting, closure with full RTW or referral to the Colleague Relations team for Americans with Disability Act considerations or the Leave Administration leave for leave requests.
Coordinates with Colleague Health for treatment, testing and counseling to colleagues following blood/body fluid exposure.
Updates and maintains the OSHA Log and accuracy of annual reporting for the Health System.
Acts as a liaison between outside insurance companies and MHS affiliate colleagues under the insured worker’s compensation programs to ensure timely reporting of injuries, early return to work, and prompt payment of medical bills. Maintains files on injured colleagues, monitors and communicates financial information to affiliates.
Works as a collaborative member of the Benefits department. This includes participating in the development and delivery of colleague benefits and wellness programs, Open Enrollment, Leave Management and more.
Assists in the administration of the absence management benefit plans including PTO, sick, and short term disability. Develops, reengineers and administers procedures in alignment with system capabilities and organization policies for administration of paid time off benefits.
Assists in administering and delivering the Wellness program. Assists in evaluating colleague wellness trends and partners with benefits staff to recommend changes to benefit programs based on the need.
Creates documentation for new processes and accurately updates existing documentation based on enhancements made to existing processes. Creates and monitors processes and supports continuous improvement efforts.
Responsible for collaborating in and leading projects associated with leave of absence, wellness or benefit related plans.
Maintains confidentiality related to all information and records.
Maintains professional growth and development through continuing education, seminars, workshops and professional affiliations.
Performs other related work as required or requested.
The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform tasks other than those specifically presented in this description.
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