Workers’ Compensation Claims Manager

• →Provide hands-on oversight of a high-volume workers’ compensation claims program, with emphasis on Pennsylvania and Michigan claims and exposure across multiple jurisdictions.
• →Evaluate complex, disputed, and high-exposure claims, including compensability, investigation, medical strategy, reserves, litigation, and settlement recommendations.
• →Direct and challenge the TPA to ensure proactive claims handling, appropriate action plans, and timely progression toward resolution.
• →Review medical information and coordinate with occupational health professionals to evaluate causation, treatment, work status, and appropriate medical resources.
• →Evaluate recommendations from and collaborate with outside counsel to establish appropriate strategies for contested and litigated claims.
• →Analyze claims data to identify frequency, severity, duration, and cost drivers and recommend program improvements.
• →Partner with Safety, Occupational Health, and the business on investigations, injury trends, return-to-work opportunities, and claim-related improvements.
• →Communicate claims insights, emerging risks, and improvement recommendations to internal stakeholders and leadership.

• Drive thorough, consistent, and evidence-based decisions on complex and disputed claims.
• Hold the TPA accountable for proactive claims management, clear action plans, and timely execution.
• Turn claims data into actionable insights that identify trends, cost drivers, and opportunities for improvement.
• Build strong partnerships across the business that improve investigations, return-to-work coordination, and claim outcomes.
• Identify and implement practical improvements that strengthen the overall workers’ compensation program.

• You bring extensive workers’ compensation claims-management experience, including strong Pennsylvania expertise and experience managing claims across multiple jurisdictions.
• You have experience navigating complex medical, disputed, litigated, and high-exposure workers’ compensation claims.
• You can analyze medical information, recognize when you need additional expertise, and ask the right questions to inform claim strategy.
• You have experience directing claims professionals or a TPA and holding partners accountable for claim progression and outcomes.
• You enjoy working directly with complex claims while also using data and business insight to improve the broader workers’ compensation program.

• 10+ years of substantive workers’ compensation claims-management experience.
• Strong Pennsylvania workers’ compensation claims expertise with experience managing claims across multiple jurisdictions.
• Demonstrated experience managing complex, disputed, litigated, and high-exposure claims.
• Strong medical claims-management and investigation experience.
• Experience directing claims professionals or overseeing a third-party administrator.
• Experience collaborating with outside counsel on contested and litigated workers’ compensation claims.
• Ability to independently evaluate claim strategy, medical information, investigation findings, and resolution options.

• Michigan workers’ compensation claims exposure.
• Workers’ compensation experience supporting manufacturing, agriculture, or similarly complex occupational environments.
• Experience in a self-insured, high-deductible, or significant retained-risk environment.
• Subrogation experience.

• Uses evidence, investigation, and sound judgment to make difficult claims decisions.
• Takes ownership of claims and follows through until appropriate resolution.
• Uses claims data to identify trends, risks, and improvement opportunities.
• Communicates clearly and builds productive working relationships across business, medical, financial, claims, and legal stakeholders.

You will have meaningful ownership of an established workers’ compensation program, access to on-site occupational health resources, and the opportunity to introduce improvements that directly influence claims outcomes and business performance.

A planned transition with the incumbent will provide an opportunity to understand the existing program while preparing to take ownership of its future direction.

If you are an experienced workers’ compensation claims professional who wants to combine hands-on claims expertise with broader program ownership and improvement, we encourage you to explore this opportunity.

Clemens Food Group does not accept unsolicited resumes from search or staffing firms. All resumes submitted by search or staffing firms to any employee at Clemens Food Group via email, the Internet, or directly without a valid written search agreement for this role, and without having been asked to participate in this by Talent Acquisition, will be deemed the sole property of Clemens Food Group, and no fee will be paid in the event the candidate is hired. Firms not authorized to submit candidates will not be eligible for any fee or ownership claim.

It is the policy of Clemens Food Group to provide equal employment opportunity (EEO) to all persons regardless of age, color, national origin, citizenship status, physical or mental disability, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status, or any other characteristic protected by federal, state or local law. All employees are subject to a pre-employment screening process including a background check and drug screen. We will also provide reasonable accommodation for qualified individuals with disabilities. If you require reasonable accommodation in completing the application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to your recruiter.