Director, Claims

DESCRIPTION

Puget Sound Workers’ Compensation Trust and Unemployment Pool (PSWCT/UP) seeks an experienced Director of Claims to provide leadership and subject matter expertise to a well-established, high-quality claims handling function encompassing the management of workers’ compensation and unemployment compensation claims. The role is responsible for the development, implementation, and management of initiatives and strategies, grounded in best practices, to mitigate loss while optimizing school district membership value and maximizing the injured worker experience. The Claims Director will collaborate with internal and external partners and a dynamic group of certified claims professionals, along with imbedded attorney and case management personnel, to inform the execution of tools and methods in delivering the best possible claims experience.

This job reports to Executive Director, WCT/UP

Open until filled; for best consideration, submit a complete application by best consideration date of 11/10/2024.
 
PSESD is one of nine regional educational agencies serving school districts and state approved charter and private schools in Washington. Serving over 39% of Washington’s K-12 public school students, our agency provides critical services designed to ensure that our students are ready to enter school, achieve at high levels in the K-12 system, and succeed in postsecondary endeavors. We are committed to becoming an Antiracist Multicultural Organization driven by equity in education. To learn more about PSESD, visit www.psesd.org/about-psesd.

PSWCT/UP (a department of Puget Sound Educational Service District) is a group self-insured program for workers’ compensation and unemployment compensation coverage for 35 school districts and PSESD and their 45,000 employees in King, Pierce, Skagit, Snohomish, and Whatcom counties.
 

Essential Functions

• Analyzes data/information specific to claims handling activities for the purpose of making and implementing recommendations through new and revised policies and procedures.

• Develops staff objectives and goals for the purpose of ensuring staff understand performance expectations, receive regular feedback and coaching, and are appropriately rewarded and developed. 

• Embodies the principles and practices that form our culture and commitment to becoming an Antiracist Multicultural Organization for the purpose of meeting the Agency’s End: Success for Each Child and Eliminating the Opportunity Gap by Leading with Racial Equity.

• Engages staff to confirm assignments and tasks are commensurate with experience and capabilities, and that they receive proper orientation and on-going training and professional development to be the best version of themselves.

• Leverages  technical expertise for the purpose of providing direction and coaching in various areas such as compensability determination, investigation, coverage interpretation, reserve management, and settlement. 

• Manages and directs a team of claim handling professionals for the purpose of ensuring delivery of best practice  claim handling services to member school districts that adhere to policies/procedures and are consistent with industry and state regulatory standards.

• Manages approval authority criteria for reserve management, payments, and settlements for the purpose of expediting the claim handling process and avoiding unnecessary delays and missed opportunities. 

• Monitors new and emerging regulations/legislation/policies for the purpose of assessing impact on claim handling practices, making recommendations to executive leadership, and ensuring compliance to avoid penalties and negative branding.

• Oversees the claim handling staff for the purpose of achieving stated outcomes, maintaining adequate staffing levels, optimizing productivity, and accomplishing objectives within budget.

• Procures necessary and adequate resources for the purpose of providing access to claim handling staff in support of their work and cultivating a best practice claim handling environment. 

• Reviews and analyzes claim files for the purpose of providing constructive feedback and coaching to staff to optimize claim outcomes.

• Supports administrators and agency staff for the purpose of responding to requests and/or making recommendations.

Other Functions

• Assist other personnel as may be required for the purpose of ensuring an efficient and effective work environment.

JOB-SPECIFIC COMPETENCIES

ANTIRACIST LEADERSHIP COMPETENCIES

CULTURAL PROFICIENCY: Articulates and applies historical context of racism and understands the current reality of students and communities of color in order to support racial equity. Actively demonstrates a commitment to supporting equity and inclusion, and serves as an advocate with colleagues, partners, and communities to meet the Agency's End and goal of becoming an Antiracist Multicultural Organization in support of eliminating the opportunity gap.

RACIAL EQUITY ADVOCATE: Recognizes, supports, and engages in dismantling institutional racism. Partners with and is accountable to those with whom we are in a transformational relationship, including children, families, and communities of color.

RACIAL EQUITY MINDSET: Demonstrates awareness of biases, internalized racial superiority and oppression. Leads with a racial equity lens and actively uses the racial equity tool in meaningful ways.

TRANSFORMATIONAL VALUES: Contributes to valuable and positive, antiracist transformation in individuals, organizations, and social systems in an effort to actively progress across the antiracist multicultural institution continuum. Is able to foster a sense of community and shared purpose via collaboration and cooperation with others inside and outside PSESD. Embodies the principles and practices that form the Agency’s culture. Operates from an abundance mentality that recognizes opportunities, and is optimistic and realistic about the future.

JOB-SPECIFIC COMPETENCIES

ACCOUNTABILITY: Takes responsibility and ownership for successfully accomplishing work and Agency objectives and delivering results. Sets high standards of shared performance for self and others.

BUILDING EFFECTIVE TEAMS: Builds a diverse and cohesive team who work together toward shared goals. 

CLAIMS MANAGEMENT: Administers the claims process from start to finish, utilizing case management best practices, risk analysis, critical thinking, and interpersonal skills.

MANAGING AND MEASURING WORK: Prioritizes and organizes work plans based on objectives and desired outcomes. Collaborates and shares responsibility for decisions and monitors progress toward goals by establishing strong feedback channels.

RISK ANALYSIS AND MANAGEMENT: Identifies, defines and analyzes risks to the Agency, represented districts, programs, staff, and students posed by potential adverse actions or events. Plans, communicates, and implements measures that will avoid, reduce, overcome, or compensate for elements of risk.

MINIMUM QUALIFICATIONS

• Bachelor's Degree in Risk Management, Insurance, or related field 
  • AA degree in Risk Management, Insurance, or related field and 3+ years of progressively responsible work-related experience, or
  • A high school diploma/GED or equivalent and 6+ years of progressively responsible work-related experience may substitute for Bachelor’s degree
• Previous experience managing workers’ compensation claims in Washington State
• Previous claims supervisory/leadership experience 
• Washington State-certified claims administrator designation or certification achieved within 2 years of hire

PREFERRED QUALIFICATIONS

• Origami Claims Management System proficiency
• Experience utilizing claims analytics to inform quality measures
• Knowledge of workers’ compensation claims and risk management best practices
• Previous unemployment insurance claims management experience 
• Experience coordinating and executing claim-related client stewardship activities

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