Workers Compensation Program Coordinator-RN

Schedule

Full Time: Monday - Friday Days; Hybrid 50% or more onsite

General Summary

Develops, implements and assesses the effectiveness of occupational action plans for injured/ill System employees. Provides internal workers' compensation case management, including attending appointments with injured/ill employees when needed. Tracks/trends data regarding work-related injuries/treatment. Acts as liaison with third-party administrator (TPA).

Duties and Responsibilities

Essential Functions:

• Aids in the development, implementation, and maintenance of workers' compensation programs, policies and procedures to meet and/or exceed state & federal regulatory requirements.
• Responsible for ensuring that all requirements needed to achieve and/or maintain WSH's self-insured status are fulfilled on time and in full, including applications, annual state and bureau reporting, etc..
• Functions as key contact in managing and communicating with outside vendors, regulatory bodies and legal staff in all matters related to workers' compensation and related regulatory bodies.
• Assists in developing, establishing, and implementing goals, objectives, and policies and procedures for the program which guide and support the provision of the department's services.
• Designs and monitors metric reporting and tracking to provide meaningful data to manage and mitigate injury/illness trends.
• Assists with tracking of work-related injury/illness for trending purposes. Analyzes data and prepares appropriate reports on Department metrics. Communicates with EHS Leadership and Safety Specialists about injury patterns and accident investigation recommendations.
• Ensures that requests for information (subpoenas, records, notices, etc.) related to workers' compensation are responded to / returned in accordance with WSH standard work.
• Collaborates with TPA on activities to ensure WSH quality of care for injured workers and manages claims costs to ensure consistency and efficiency. Triages urgent issues and elevates concerns to Department Leadership.
• Facilitates case/chart reviews and develops/oversees action plans designed to expedite care and drive claims closure. Coordinates quarterly claims review meetings.
• Assesses new cases by gathering information, reviewing diagnoses and injury reports, and analyzing test results. Keeps accurate medical records, ensuring highest priority to patient confidentiality.
• Approves/submits reimbursement of expense for outside services, employees, and customary charges. Reviews workers' compensation payment reports provided by third party administrator or internal write offs for accuracy.
• Educates team members about their plan of care, treatment and care options, and assists in helping to make decisions, including scheduling appointments for doctors' visits, therapies, and other necessary services. Engages with treating providers to resolve issues when necessary.
• Provides telephonic and field case management when necessary for complex cases or at the direction of EHS Leadership. Communicates with injured employees, treating providers and supervisors about work-related injuries/illnesses.
• Assists the Workers' Compensation Coordinators with development, implementation and coordination of the Alternative Duty program when needed, including work assignments, payroll, timecard review, PTO requests, and leave of absence submittals.

Common Expectations:

• Demonstrates a commitment to patient, visitor and staff by: complying with all applicable safety regulations; learning the impact of medical errors and methodology that will lead to reduction of errors; reporting actual and potential errors, as well as hazardous conditions; identifying opportunities to standardize processes and "error proof" systems that will lead to increased safety; and participating in safety education programs and root cause analyses as required.
• Fosters teamwork with professional leadership style and effective communication. Provides coaching and positive dialog to department team members.
• Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.
• Participates in/contributes to staff and department meetings.
• Orients new employees as needed.
• Provides outstanding service to all customers; fosters teamwork; and practices fiscal responsibility through improvement and innovation.

Benefits Offered

• Comprehensive health benefits
• Flexible spending and health savings accounts
• Retirement savings plan
• Paid time off (PTO)
• Short-term disability
• Education assistance
• Financial education and support, including DailyPay
• Wellness and Wellbeing programs
• Caregiver support via Wellthy
• Childcare referral service via Wellthy

Required for All Jobs:

• Performs other related duties as identified.
• WellSpan Health has adopted and implemented a compliance program to support WellSpan's values and standards for professionalism, integrity, and ethics. Expected to support and meet the values and standards of the organization and the performance expectations of the job, the department, and the compliance program.
• WellSpan Health has adopted and implemented a privacy program to safeguard the patient information and the business and operational information of the organization. Expected to support and meet the values and standards of the organization to safeguard patient and business/operational information.

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

Physical Demands:

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Frequently
• Reaching - Rarely
• Talking - Frequently
• Hearing - Frequently
• Repetitive Motions - Occasionally
• Eye/Hand/Foot Coordination - Occasionally

Qualifications

Minimum Education:

• Bachelors Degree Required

Work Experience:

• 2 years Required
• Case Management/Workers' Compensation experience and experience with PA Workers Compensation law Preferred

Licenses:

• Licensed Registered Nurse Upon Hire Required or
• Registered Nurse Multi State License Upon Hire Required
• Certified in Case Management Upon Hire Preferred

Knowledge, Skills, and Abilities:

• Advanced understanding of Excel and other Microsoft Office software
• Excellent communication and writing abilities, effective at presentations to small and large groups
• Coaching/team building
• Policy writing