Risk Manager

• Job Code: U8729
• Pay Grade:UE
• Pay Scale:$69,888.00-$113,971.20 Annually
• Exempt:Yes

Overview

The Risk Manager will lead the Sheriff’s Office claims management activities (e.g., workers’ compensation, personal claims, short- and long-term disability, fitness for duty, automobile) and use trackable data to advance the risk management team’s overall strategy and daily operations. This role is primarily responsible for preserving financial assets to mitigate the best claims outcomes, performing incident investigation and risk control activities related to insurance coverages, and assisting in the coordination of transitional modified duties, legal proceedings, and resolution strategies. In addition, the Risk Manager will collaborate with other divisions to ensure proper adjudication of agency policies and various laws that are applied to employees with on-the-job injuries; conduct field personnel training on the worker’s compensation management processes; and assist with championing safety communication for sworn and civilian personnel.

Duties & Responsibilities

Note: Depending on assigned responsibilities, employees may perform some or all of the duties below.

• Manage and oversee all claim-related activities including managing vendors (e.g., legal, medical case management, surveillance) and third-party providers (e.g., brokers, insurers, and third-party administrators (TPAs)), liaising with the HCSO Legal Office on all claim-related matters, and resolving claim disputes with carriers according to industry standards, best practices, and agency policy.

• Manage internal agency relationships related to all insurance programs.

• Collaborate and coordinate with TPAs and outside counsels to perform internal litigation management; identify any actual or potential issues resulting from TPAs or outside counsels that could impact claim outcomes.

• Review and approve all action plans recommended by the claims administrator or TPA on claims and make recommendations to expedite positive claim outcomes as needed throughout the life of the claim.

• Interact with legal counsel, insurance carriers, TPAs, and patients/families to affect timely settlements of claims and approve all case reserves and claim settlements based on established guidelines.

• Conduct and participate in claims committee conferences as needed on complex claims.

• Obtain all pertinent claim information and documents from the claims adjuster; apprise managers with initial assessment before the claim is reported to initiate the claims adjudication process immediately.

• Support accounting and budgeting activities associated with insurance claims costs and other related litigation costs including reviewing, auditing, and processing for payment any related claims or litigation invoices and ensuring timely payment of claim invoices and/or any refunds of settlements.

• Oversee medical leave and return to work compliance including reviewing and investigating all first reports of employee injury, contacting injured employees to determine their current medical status and needs within 24 hours, providing guidance regarding follow up care, and communicating the workers’ compensation process and expectations.

• Monitor employee compliance with medical treatment and transitional duty assignments on an ongoing basis as warranted until closure (e.g., fitness for duty form); provide regular internal status updates on injured employees to applicable agency personnel.

• Coordinate fitness for duty evaluations.

• Act as the agency Americans with Disabilities Act (ADA) Compliance Officer.

• Create templates and support the team to ensure the risk management team can operate smoothly through a variety of dynamic legal and operational issues; provide mentorship to team members.

• Develop reporting mechanisms to improve communications and transparency with agency stakeholders and present reports and analyses to the management chain; coordinate the safety/occurrence reporting process.

• Prepare ad hoc presentations to internal divisions on insurance programs and exposures.

• Document industry benchmarking and metrics; prepare loss analyses identifying exposures, recommending solutions, and implementing approved programs.

• Collaborate and coordinate with applicable parties to ensure accuracy of claims data, analytics, claims costs, and various value-added reports.

• Participate in championing safety communications for sworn and civilian staff (newsletters, posters, social media, etc.).

• Train department heads and field level employees on risk management and claims related best practices with respect to on-the-job injuries and return to work.

• Provide in-service training to Occupational Health and Wellness Center (OHWC) employees and medical staff to enhance safety awareness and their roles in preserving OHWC assets and reducing liability exposure.

• Lead agency risk control services including pre-accident and post-accident investigation when necessary.

• Complete periodic risk assessment exercises (e.g., recurring and ad hoc audits, incident remediation, escalations) to periodically review programs and improve internal processes to mitigate risk.

• Assist in providing agency guidance on adherence to civil rights laws and respond to requests for reasonable accommodations.

• Perform other related duties as required.

Knowledge, Skills & Abilities

• Considerable knowledge of automobile, personal claims, short-term and long-term disability, FMLA, and/or workers’ compensation claims processing rules and regulations.

• Working knowledge of the ADA.

• Strong interpersonal skills.

• Skill with Microsoft Excel and PowerPoint.

• Ability to collect, organize, and evaluate data to develop logical conclusions.

• Ability to multi-task in a fast-paced environment.

• Ability to work effectively with internal and external entities.

• Ability to pay attention to detail.

• Ability to plan, organize, and review the work of others.

• Ability to communicate effectively, both orally and in writing.

• Ability to form and maintain productive working relationships.

• Ability to handle confidential information.

• Ability to use a computer and related software.

Minimum Education & Experience

• Bachelor’s degree from an accredited institution of higher education with major course work in business, risk management, or a related field.

• Five years of experience in an insurance company, brokerage firm, risk management, or public safety department.

Additional Job Requirements

• Attendance at the specified Sheriff's Office work location is required.

• Depending on assignment, employees may be required to possess a valid Florida Driver License at time of employment. Driving history will be thoroughly reviewed and may be grounds for disqualification.

• No visible tattoos on face, head, and neck. Tattoos determined to take away from the professional appearance of the Sheriff’s Office must be covered with an appropriate white, black, or neutral covering.

• No illegal drug sale within lifetime.

• No illegal drug use within the past 36 months. No marijuana use within the last 12 months.

• No felony convictions within lifetime.

• No misdemeanor convictions involving perjury, false statement, or domestic violence within lifetime.

• No dishonorable discharge from any branch of the United States Armed Forces, the United States Coast Guard, National Guard, or Reserve Forces.

• Successful completion of a background investigation including criminal, reference, employment, and neighborhood checks; polygraph; medical evaluation; and drug screening.

Preferred Qualifications

• Experience with self-insured or large deductible programs.

• Prior managerial experience.