Vice President, Workers' Compensation Claims Consulting
New
E
EnlyteWorkers' compensation
This is a remote position and can be located anywhere in the US.Full-TimeVp
Salary$190,000 - $225,000 annually plus bonus and equity opportunities
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Job Details
- Experience
- 15+ years of experience
Requirements
- Hold a bachelor's degree in Operations Research, Risk Management, Insurance, Healthcare Administration, Business Analytics, a related field, or equivalent experience.
- Bring 15+ years of experience in workers' compensation consulting, managed care consulting, process reengineering, or payer/carrier leadership.
- Have a track record of managing in a remote and matrixed environment.
- Demonstrate claims operations expertise and understanding of regulatory constraints, medical management, and return-to-work objectives.
- Have experience with technical data analysis using BI.
- Interpret internal benchmarks alongside external industry trends and market dynamics to anticipate workers' compensation claims and operational challenges.
- Foster collaboration across departments including Compliance, Marketing, Clinical, and Analytics.
- MBA or an industry certification that reinforces process reengineering, workers' compensation expertise, or analytics is preferred.
Responsibilities
- Advise senior executives at workers' compensation carriers, TPAs, and self-insured employers on claims outcomes, operational performance, and financial results.
- Lead consulting engagements from assessment through implementation and help clients execute measurable improvements.
- Develop and present executive-level recommendations covering claims operations, medical management, return-to-work strategies, and organizational objectives.
- Assess claims operations, workflows, staffing models, and performance metrics to identify opportunities for improvement.
- Recommend operational, clinical, and process improvements to reduce claim costs and duration and improve outcomes.
- Analyze claims data, operational metrics, and industry benchmarks to identify trends, risks, and opportunities.
- Coordinate internal clinical, regulatory, analytics, product, and operational experts to deliver and implement client solutions.
- Measure and communicate initiative impact using performance indicators and business outcomes.
- Contribute to consulting methodologies, tools, and service offerings.
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