SUMMARY
The Director, Safety & Risk Management will lead and oversee the end-to-end management of all workers’ compensation claims, ensuring timely, compliant, and cost-effective resolution. This position serves as the primary liaison with Third-Party Administrators (TPAs), carriers, medical providers, and internal stakeholders, while promoting a safe work environment and supporting injured employees through the claims process. The role includes driving claims strategy, ensuring adherence to regulatory requirements, facilitating return-to-work programs, and leveraging data to identify trends and recommend process improvements.

ESSENTIAL FUNCTIONS, RESPONSIBILITIES AND DUTIES

Workers’ Compensation Strategy & Oversight:

• Lead the full lifecycle of workers’ compensation claims, from first report of injury through closure, ensuring timely processing, accuracy, and compliance with all applicable laws.
• Assess medical treatment plans, reserves, and settlement values; leverage carrier claims management systems to monitor and guide claim resolution.
• Serve as the subject matter expert on workers’ compensation best practices, policies, and procedures.

TPA & Carrier Partnership:

• Act as the primary liaison with TPAs and workers’ compensation carriers to facilitate claim investigations, medical management, and settlement negotiations.
• Build and maintain effective working relationships with external partners to ensure efficient claim handling and positive outcomes.

Claim Investigation & Documentation:

• Oversee and/or conduct thorough investigations of reported incidents, including gathering required documentation, witness statements, and other evidence to support claim adjudication.
• Ensure all records are accurate, organized, and compliant with regulatory and company standards.

Communication & Stakeholder Engagement:

• Maintain clear, timely, and empathetic communication with injured employees, HR, Operations, Safety, and external partners regarding claim status and next steps.
• Provide guidance to managers and employees on workers’ compensation processes, rights, and responsibilities.

Compliance & Regulatory Adherence:

• Ensure all claims activities comply with applicable state and federal workers’ compensation laws, reporting requirements, and internal policies.
• Monitor legislative changes impacting workers’ compensation and update processes as needed.

 Return-to-Work & Accommodation Coordination:

• Partner with TPAs, medical providers, and internal leaders to coordinate return-to-work programs, including light-duty assignments.
• Develop creative, compliant solutions to support injured employees’ successful reintegration into the workplace.

Data Analysis & Reporting:

• Track and analyze claims metrics to identify trends, assess program performance, and recommend improvements.
• Provide regular reports on claim status, financial exposure, and outcomes to management.

Training & Education:

• Develop and deliver training on workers’ compensation reporting procedures, safety awareness, and injury prevention.
• Monitor participation in required training programs to ensure compliance and reinforce safety culture.

 Continuous Improvement:

• Identify opportunities to streamline claims processes, improve cost efficiency, and enhance the employee experience.
• Collaborate with cross-functional teams to integrate workers’ compensation practices into broader safety and HR initiatives.

General Support:

• Take on additional responsibilities or interim assignments as business needs evolve.

Education

• Bachelor's degree in a related field (e.g., Business Administration, Human Resources, Risk Management) or equivalent practical experience.

 Experience

• Minimum of 10-15 years of direct experience managing workers' compensation claims in the US, specifically within a high-volume workforce
• In-depth knowledge of NY, NJ, PA, IL and MA Workers' Comp claims regulations and reporting requirements.
•  Proven experience working effectively with TPAs and Workers' Compensation Carriers.

Skills and Competencies

• Exceptional communication (written and verbal), interpersonal, and negotiation skills.
• Ability to manage a high volume of claims and prioritize effectively in a fast-paced environment.
• Empathy and a strong commitment to supporting injured workers while protecting company interests.
• Ability to maintain confidentiality and handle sensitive information with discretion.