| Department: Risk Management
Salary/Grade: EXS/9 Job Summary: The Claims Manager will work under the supervision of the Director, Risk Management and Insurance to help manage Northwestern’s insurance and risk finance programs. Primary responsibility of the Claims Manager will be overseeing and managing the University’s self-insured workers’ compensation program, including investigation, medical coordination, claim adjudication, and settlement negotiation. The role will also be responsible for preparing appropriate strategy for departmental partners, assisting with renewal applications and complying with mandatory requirements as dictated by the State of IL. This role may include supervisory responsibilities of an on-site risk analyst and claims management of non-WC insurance claims. Specific Responsibilities: Claims Management - Ensures execution of self-insured workers compensation claim handling strategies, including appropriate determination of coverage and claim resolution.
- Assists injured employees in obtaining appropriate and immediate medical assistance with University’s two occupational medical providers in the event of an incident.
- Coordinates with employee and occupational healthcare providers for any following up medical visits and arranges additional medical testing, if necessary, in order to facilitate the University’s return to work plan.
- Works closely with key departmental contacts to provide special accomodations when work restrictions are provided to the employee to facilitate timely return to work.
- Maintains all internal claims data by properly setting indemnity and medical reserves in the electronic claims system, Origami Risk. Pays all TTD and medical obligations, with coordination of Human Resources, for medical leaves and coordinates with medical management nurse when appropriate.
- Establishes and maintains effective working relationships with campus partners, vendors, and outside counsel.
- Responsible for managing and guiding all workers’ compensation settlement negotiations when applicable with assistance from outside counsel.
- Be “on call” and availability for emergency response in absence of Director, Risk Management.
Commercial Insurance Program Management - Assists the Director of Risk Management in the insurance renewal process as related to workers’ compensation, loss history, and safety initiatives.
- Reports high value losses to excess commercial insurance carriers when losses are reasonably expected to exceed the University’s self-insured retention.
Operational Risk Management - Participates in discussions regarding risk, safety, and educational programs for University students, faculty and staff.
- Consults with the Environmental Health & Safety team to perform internal claims investigation post-incident. Provides further assistance in the development and implementation of preventative programs in identified areas of concern.
- Serves on University, campus, and other committees/teams in absence of the Director of Risk Management.
- Act as a liaison to Research Safety and Facilities departments by supplying analytics and trend analysis when requested.
Regulatory Administration - Prepares mandatory workers compensation State of IL Self-Insured Application as well as State of Illinois Injury Fund Assessments.
- Responsible for electronic submission to Bureau of Labor Statistics OSHA’s Form 300 as well as electronic submission to OSHA (ITA) Injury Tracking Application.
- Oversees compliance of EDI notifications to State of Illinois and Medicare.
- Other duties as assigned.
Minimum Qualifications: - Successful completion of a full 4-year course of study in an accredited college or university leading to a bachelor’s or higher degree in a major such as insurance, business, or finance.
- 4-6 years of insurance experience, either at an insurance carrier, third party administrator, and internal risk management function.
Minimum Competencies: (Skills, knowledge, and abilities.) - Strong technical aptitude and understanding of commercial insurance coverage.
- Strong communication skills.
- Ability to work with a diverse set of stakeholders and provide excellent customer service.
- Strong time management and project management skills.
- Basic understanding of claims management and risk finance.
- Strong desire to learn and take on additional responsibility.
Preferred Qualifications: - ARM, CPCU or other professional designations.
- 7+ years of commercial insurance and/or workers’ compensation claims management experience.
Preferred Competencies: (Skills, knowledge, and abilities) - Proficient in safety and loss prevention measures.
- Strong knowledge of workers’ compensation regulatory landscape.
- Customer Service.
Northwestern University is an Equal Opportunity, Affirmative Action Employer of all protected classes, including veterans and individuals with disabilities. Women, racial and ethnic minorities, individuals with disabilities, and veterans are encouraged to apply. Hiring is contingent upon eligibility to work in the United States.
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