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Workers' Compensation Return to Work Case Manager

2 months ago

Springfield, United States Baystate Health Full time

Baystate Health, a nationally recognized leader in healthcare quality and safety, and home to Baystate Rehabilitation, a comprehensive rehab program providing services throughout western Massachusetts is looking for a full time Workers Compensation, Return to Work Case Manager to join our team in Springfield, MA. DEPARTMENT DESCRIPTION: Teamwork, flexibility, peer support SCHEDULE: Monday- Friday 8:00 am - 4:30 pm Full time - 40 hours This is a commutable remote position Remote work option available for local applicants within a commutable distance from the designated Baystate Health entity. LOCATION: Corporate Office 280 Chestnut Street, Springfield, MA THE ADVANTAGES OF WORKING WITH BAYSTATE Excellent Compensation High-quality, low-cost medical, dental and vision insurance Generous PTO – up to 25 days in the first year, with scheduled earned increases Continuing education support and reimbursement First Time Home Buyers Financial Packages Farm Share Memberships 403b retirement company match & annual company contribution increase based on years of service Free money coach advice from a certified professional Wellbeing programs that include but are not limited to mental, physical, and financial health Pet, home, auto and personal insurance Life insurance Reimbursement for a variety of wellbeing activities, included but limited to gym membership and equipment, personal trainer, massage and so much more Wellbeing programs that include but are not limited to mental, physical, and financial health Onsite parking (Wing, Noble and BFMC posting only) Baystate Health, western Massachusetts’ only academic center and tertiary care provider has a long and proud tradition of continuous learning and improvement. We educate and train hundreds of healthcare workers every year and advance knowledge about new approaches to care. At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. We are committed to increasing diverse representation across our organization. Together our inspired and compassionate teams manage the whole health needs of all communities in need. QUALIFICATIONS: Bachelors of Science We strive to be the place where we can help you build the career you deserve – apply today – YOU belong at Baystate Summary Description: Workers' Compensation & Return to Work (RTW) Case Manager will manage workers' compensation claims across all Baystate Health entities. This role will orchestrate the full claim process from claim initiation to resolution in compliance with the Commonwealth of Massachusetts statutes while providing crucial support to injured workers on their journey to recovery. Additionally, the case manager will perform work in the administration of the self-funded plan; including annual assessments and renewals for the Department of Industrial Accidents, data requests for excess workers’ compensation plan and Baystate Health Insurance Captive as needed. This role will also manage all activities associated with returning an injured employee to work in coordination with the RTW team which includes the Baystate Health (BH) injured employee, Employee Health Services and medical providers, managers/supervisors, ADA Case Manager, Safety, and Human Resource areas. This is accomplished with the following: 1) developing a systems approach to care delivery for a given patient population (injured employees) across the care continuum; 2) assume case management role with implementing initiatives that improve quality, efficiency, and injury care cost; 3) demonstrate compassion, inclusiveness, and raising the standard of excellence to achieve maximum value and outcomes. 4) have regular meeting with Department managers to promote the Modified Duty Program. Reports to Leave and Accommodations Manager. Position is required to work periodically onsite for management and employee meetings; development of RTW plans and development of modified duty opportunities. Job Requirements: 1) Coordinate and implement case management and review of workers' compensation cases in conjunction with the third-party administrator. Analyzes and resolves questions dealing with a workers' compensation injury or occupational disease; acts as liaison with the third party administrator and interpret and clarify complex statutes and regulations in regard to workers' compensation 2) Manage workers' compensation claims from start to finish, including reporting, investigating, and tracking claims. Serve as the main point of contact for employees regarding workers' compensation issues, providing guidance and support throughout the claims process. 3) Support and participate in claim reviews and litigation discussions with third party administrator and defense counsel. Track all settlement cases and ensure appropriate documentation/HR system updates. 4) Collaborate with Employee Health Services, Leave & Accommodation team, HR, supervisors, and injured employees to ensure accurate and timely reporting of all workplace injuries and illnesses. Liaise with insurance providers, legal professionals, and healthcare providers to facilitate the timely processing of claims and effective communication between all parties involved. 5) Assist department manager in the administration of self-insured and fully-insured workers’ compensation plans as well as excess workers’ compensation plan. Assist with annual renewals, annual applications and payroll audits for various plans with the collection and remittance of loss runs, salary exposures by WC classifications, federal 941 tax forms, employee census and payroll reports. 6) Review referrals and existing WC claims to identify any potential modified duty opportunities and provide services in a timely manner. Obtain functional capacity details, i.e., restrictions and limitations and the time period for which limitations are effective. Identify appropriate light duty or modified duty opportunities to support employees RTW strategy. Manage the process of transitioning by ensuring that employees returning to work after an injury can re-acclimate to their working environment, duties and responsibilities in the most efficient and effective way possible. May visit worksites of employees on modified duty to ensure a good match for managers and the employees on modified duty. 7) Promote and manage the Return to work Program, facilitate meetings with departments, and influence managers to accept restrictions in current and non-essential roles to facilitate work hardening for employees in the Return to Work Program. Manage the tracking of lost time and modified duty days for accuracy in obtaining meaningful data for BH program effectiveness and budgeting. 8) Support administration of ADA program through collaboration with ADA Case Manager, assisting with intake and transition from PML and FMLA to ADA protection and communications during intake process. Minimally Required Expereince: Demonstrated knowledge of workers' compensation claim management laws, medical and legal terminology. 5 years work experience in three or more of the following: Workers' Compensation underwriting and claim administration (including working with legal professional, TPAs, insurance providers); Risk Management; occupational/employee health; performing ergonomic evalutions; nursing administration or Environmental safety role Preferred Experience: Certification in workers' compensation administration prior workers' compensation claims experience at healthcare organization Skills/Competencies: Problem-solving and decision-making skills to assess and determine the validity of workers' compensation claims. Strong interpersonal skills with the ability to empathize and provide support to injured employees while handling stressful situations with professionalism. Ability to create collaborative and respectful relationships with all key stakeholders to facilitate claims momentum. -Strong knowledge of ADA/EEOC laws -Excellent computer skills, including MS Office, Workday or other HR system Administration -Proven proficiency in compiling, organizing, analyzing, and reporting data, using common data analysis tools such as Excel Data -Excellent written and verbal communication skills -Excellent interpersonal skills – demonstrated ability to build productive partnerships with internal and external constituents; especially with employees during difficult situations -Demonstrated strong, influential, leadership and analytical and problem solving skills -Strong sense of urgency and confidentiality OUR COMPENSATION PHILOSOPHY We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role. You Belong At Baystate At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people. DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS. Education: Bachelor of Science (Required) Certifications: Equal Employment Opportunity Employer Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status. Please be aware that after the upgrade, you will need to change any bookmarks you have to this External Career Site and your Candidate Account Login Page. Please also note that workflow emails received prior to the upgrade on 8/3/2024 contain links that will no longer work. Please plan to log into your account directly to monitor your application activity and tasks. Ab out Baystate Health Baystate Health (BH) is one of New England’s leading and largest integrated health care organizations, serving a population of nearly one million people throughout western New England. With roots dating back to the founding of Springfield City Hospital in 1873, Baystate Health has been providing high-quality and compassionate health care in western Massachusetts for more than 145 years. With more than 12,000 employees, a medical staff of nearly 3,100 physicians, and a net patient service revenue of more than $1.4 billion, the ever-growing health system includes five Massachusetts hospitals and the Baystate Mary Lane Outpatient Center in Ware: Baystate Medical Center in Springfield Baystate Children’s Hospital (located at Baystate Medical Center) Baystate Franklin Medical Center in Greenfield Baystate Wing Hospital in Palmer Baystate Noble Hospital in Westfield