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Manager, Workers Compensation

THE SCHOOL DISTRICT OF PHILADELPHIA
Oversees the implementation of the Workers’ Compensation Program for the School District of Philadelphia. Directs and oversees Workers’ Compensation activities of a third party administrator. Monitors claims activities in cooperation with the third party administrator. Provides support to District staff on the proper procedures to be followed in workers’ compensation matters.

Essential Functions

  • Oversees and works in a cooperative effort with the third party administrator (TPA); reviews and refers claims for authorization to the Director, Risk Management to take varied courses of action with regards to claims administration, including consideration of settlement, rehabilitation, medical management, vocational rehabilitation vendors, and private investigators; may work with TPA personnel to make recommendations to the Director, Risk Management to initiate petitions for hearings by the State Bureau of Workers’ Compensation or the Commonwealth Court of Pennsylvania.
  • Oversees and implements procedures for the processing of workers’ compensation claims; reviews practices and procedures to ensure that the School District is in compliance with applicable laws and regulations; ensures that claims are reported in a timely manner and monitors compliance with policies and procedures in various District locations.
  • Acts as the primary liaison for all schools on workers’ compensation matters; serves in a resource capacity and provides Worker’s Compensation information to District personnel, union representatives and attorneys; disseminates information regarding Worker’s Compensation policies and procedures; gives staff presentations on Workers’ Compensation.
  • Supervises and directs the work of the Workers’ Compensation Specialist engaged in overseeing, implementing and providing support for the District’s return to work program; ensures compliance and cooperation at all District locations and that accurate duty status information is communicated to the TPA and Worker’s Compensation payroll staff.
  • Monitors performance of the TPA with respect to medical expenses, vocational rehabilitation expenses and legal fees; ensures that vocational rehabilitation expenses do not exceed the stipulated amount.
  • Reviews case summaries prepared by the TPA and prepares independent case summaries; references industrial medicine guidelines to facilitate the review process; maintains a tickler file of cases to be further reviewed; may make recommendations for action based on the outcome of reviews.
  • Meets with physicians of the approved medical centers in order to review quality of care issues, return to work and related medical program issues.
  • Monitors all claims litigation including reviewing all correspondence issued by counsel for appropriate action; assists counsel in obtaining information from the District necessary for defense; ensures that the defense counsel takes the necessary action to support the Workers’ Compensation program.
  • Maintains records for claims oversight, including but not limited to legal decisions issued, and petitions filed; tracks penalties against the District and monitors school locations with late reporting.
  • Assists and supports the Workers’ Compensation payroll area by sharing information on claims and providing support to school locations with questions; performs wage verification matches to ensure all claimants are being paid properly.
  • Supports special projects including the District’s Savings Incentive Bond program by documenting file data, tracking payments, issuing reports on claims paid and tracking the timeliness of all payment submissions by the TPA.
  • Supports the Director, Risk Management in daily functions related to oversight and management of the workers’ compensation program.
  • Acts in a resource capacity, providing Workers’ Compensation information to School District employees, union representatives and attorneys; disseminates information regarding Workers’ Compensation policies and procedures; gives staff presentations on Workers’ Compensation. 

Knowledge, Skills and Abilities

Demonstrated knowledge of:
  • Commonwealth of Pennsylvania laws governing Workers’ Compensation.
  • current developments in the field of Workers’ Compensation.
  • the principles, methods and practices of Workers’ Compensation claims administration and processing.
Demonstrated ability to:
  • work with members of the medical and legal fields.
  • explain Workers’ Compensation policies and procedures.
  • oversee and supervise the activities of subordinate staff.
  • prepare detailed narrative and statistical reports.
  • communicate effectively, both verbally and in writing.
  • establish and maintain effective working relationships.

Selection Process

Interviews may be conducted to determine how well a candidate meets the established criteria.  Note that not all qualified candidates may be selected for an interview. The selected candidate must have no anecdotal record on file and have not been subject to any disciplinary action within the past eighteen (18) months, and have an excellent record of attendance and punctuality during the last three (3) years (defined as no more than eighteen (18) occasions of lateness or absence for personal illness in the last three years (3) years with the exception of one extended long-term absence).

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.


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