Workers' Compensation and Occupational Health Program Manager

Workers' Compensation Program Administration:

• →Operates independently as the primary administration and oversight of the University’s Workers’ Compensation, Pre-employment, and Fitness-For-Duty health programs.
• →Leads initiatives, projects, and other implementation efforts using advanced communication and listening skills; evaluates and sets work priorities; schedules and assigns work; reviews work against standards and provides performance feedback; and determines training needs and trains staff.
• →Provides functional leadership through program governance, strategic direction, and influence across departments.
• →Establish and oversee workers' compensation procedures and processes for employee groups as determined by CSURM/CPP (e.g. student live-in, resident advisors, student programs, etc.,)
• →Provide regular executive-level reports on program performance, claim trends, cost drivers, and progress made toward strategic objectives.
• →Advise the AVP on workers' compensation strategy, risk exposure, policy development, and complex case matters.
• →Partner with Employee/Labor Relations & Compliance and campus stakeholders to align policies and practices with California workers’ compensation laws and best practices.
• →Analyze, interpret, and apply new and/or existing employee group terms and conditions of employment to ensure the workers’ compensation process is accurately applied.
• →Develop and implement programmatic changes and procedural and policy changes as necessary.
• →Proactively maintain compliance with applicable state laws, regulations, and technical guidance issued by the Office of the Chancellor.
• →Oversee and manage the University’s workers’ compensation claims portfolio, including complex and litigated cases.
• →Proactively and independently investigate claims and advise the third-party claims administrator (Sedgwick Claims Management Services) regarding circumstances affecting claim outcomes. Independently attend and represent the University at workers' compensation depositions, hearings, and trials as the University's employer representative. Independently communicate to managers and supervisors the prescribed temporary work restrictions.
• →Assist the manager or supervisor with evaluating temporary work restrictions and developing the Transitional Work Plan. Initiate and guide the interactive process when work restrictions are prescribed.
• →Prepare managers and supervisors for interactions with injured workers and develop strategic communications as necessary.
• →Initiate and guide the interactive process for employees with temporary work restrictions. Exercise independent judgment while strategically collaborating with claims adjusters and legal counsel.
• →Develop pertinent documentation to support settlement authorization requests and advise leadership on the resolution strategy. Independently advise and interact with legal counsel on a regular basis regarding litigated claims. Strategically collaborate with claims adjusters, Hudson Claims Consulting, and legal counsel regarding case strategy and settlement negotiations. Maintain ongoing coordination with industrial medical clinic(s) and, where appropriate, other medical personnel regarding the status of treatment.
• →Work closely with the third-party claims administrator (Sedgwick CMS) to coordinate the University’s Workers’ Compensation caseload.

Manage Pre-Employment Health Screening Program and Fitness-For-Duty:

• →Develop and Oversee the Pre-Employment and Fitness-For-Duty Health Screening Program
• →Ensure compliance with applicable federal and state laws and bargaining agreement policies; monitor regulatory changes and implement necessary program updates. Develop and maintain policies, procedures, and internal controls to ensure consistent, equitable, and legally defensible screening practices across academic and administrative units.
• →Serve as a consultative resource to EODA and hiring managers regarding eligibility determinations, liability considerations, and complex screening outcomes.
• →Evaluate and adjudicate sensitive or high-risk screening results in collaboration with EODA leadership and legal counsel, applying institutional risk assessment and sound judgment.
• →Oversee vendor relationships to ensure service quality, confidentiality, data security, and contractual compliance.
• →Establish reporting metrics and monitor processing timelines, clearance rates, and compliance indicators to improve efficiency and reduce onboarding delays.
• →Conduct periodic program reviews and audits to strengthen compliance, mitigate risk, and enhance the candidate experience while supporting the University’s academic mission.

Develop and Provide Program Communications:

• →Serves as the University's primary point of contact for sensitive workers' compensation, pre-employment, and fitness-for-duty matters, exercising tact and judgment with claimants, providers, management, administrators, and legal representatives.
• →Advises managers and supervisors on employee communications, work restrictions, the interactive process, and return-to-work expectations; maintains strict confidentiality of health records and claim information in accordance with privacy laws.
• →Facilitates structured communication among injured employees, supervisors, Payroll, and other units on benefits, leave, transitional work, and case status; develops executive-level summaries and reports on claims activity and trends.
• →In consultation with the AVP, designs and delivers training on Workers' Compensation, Return-to-Work, and Fitness-For-Duty programs, including targeted training for Student/Academic Affairs stakeholders overseeing live-in student leaders. Provides guidance to staff accessing confidential information on liability, privacy, and reporting obligations. Maintains current knowledge of program developments and develops reference guides and orientation materials on employee rights and supervisory responsibilities.

Manage the University's Return-to-Work Program:

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  Interprets medical documentation and work status reports to determine accommodations and transitional assignments; leads RTW planning with HR, supervisors, providers, legal counsel, Payroll, and EH&S.

  Coordinates with EH&S on OSHA reporting, workplace/ergonomic evaluations, and occupational hazard mitigation; advises leadership on high-risk RTW cases involving permanent restrictions, litigation, or operational impact.

Serve as backup ADA Coordinator:

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  Helps ensure University compliance with the ADA, Sections 503/504 of the Rehabilitation Act, FEHA, and related disability-access laws.

  Provides guidance to managers, supervisors, and faculty on employment, academic, and residential accommodations; engages in the interactive process and develops individualized accommodation plans (IAPs); manages ongoing IAP case service.

  Maintains accurate, confidential ADA records and quarterly compliance tracking, including Disability Services student statistics.

• Bachelor's Degree - Education/experience equivalent to a bachelor's degree from a four-year college or university in business administration, human resources, public administration, occupational health, industrial relations, risk management, healthcare administration, occupational safety, nursing, public health, or a related field.
• Five years of progressively responsible experience administering Workers' Compensation claims, Pre-Employment Exam Programs, and Fitness-for-Duty coordination, including independently managing complex cases.
• Experience leading an integrated workers' compensation, disability management, occupational health, leave administration, or accommodation program, including developing and administering related policies and ensuring regulatory compliance and operational consistency.
• Experience coordinating return-to-work/disability management processes, interpreting applicable laws, and consulting with management on complex employee health and injury matters.
• Experience managing vendor relationships (third-party administrators, occupational health providers, consultants).
• Experience analyzing program performance data, including claims analytics, KPIs, and dashboards, and preparing management reports and recommendations for leadership.
• Knowledge of California Labor Code, FEHA, ADA, FMLA/CFRA, OSHA reporting, IDL/TD and disability benefits administration, utilization review, and California workers' compensation claims practices.
• Knowledge of occupational health administration and medical confidentiality requirements (HIPAA, CMIA, record retention); collective bargaining impacts on workers' comp, leave, and RTW programs; claims analytics and risk/loss-prevention methodologies; CSU policies, CSURMA/CSURM standards, and project/change management principles.
• Ability to interpret and apply laws and policies; analyze complex medical, legal, and operational information to develop compliant solutions balancing employee well-being and institutional needs.
• Ability to lead cross-functional initiatives and build partnerships across leadership, labor, legal, medical, and administrative stakeholders without direct authority.
• Ability to prepare and present executive-level reports and data-informed recommendations; serve as a trusted advisor on regulatory compliance, risk exposure, and program strategy.
• Ability to manage multiple priorities in a highly regulated environment with accuracy and confidentiality; exercise diplomacy and sound judgment on sensitive employee and labor relations matters.
• Exceptional written, verbal, and presentation skills, including communicating complex medical/legal/regulatory information across audiences.
• Strong analytical and problem-solving skills, with the ability to make timely, defensible decisions amid competing priorities and institutional risk.
• Demonstrated independence, initiative, discretion, and sound judgment, balanced with strong collaborative ability across organizational boundaries.

• Experience working within California State University or another public higher education institution, public agency, healthcare system, or similarly complex and highly regulated organization Workers' Compensation Certificate or professional designation such as Workers' Compensation Claims Professional (WCCP), Certified Disability Management Specialist (CDMS), Certified Leave Management Specialist (CLMS), Associate in Risk Management (ARM), or similar occupational health, disability management, or risk management credential.
• Five years of progressively responsible experience involving Workers' Compensation claims management within a large, complex, unionized, public-sector, higher education environment or a similarly regulated environment.
• Knowledge of viaOne Claims Management System Software Experience with CSU collective bargaining agreements, CMS PeopleSoft, and CHRS applications preferred. Hands-on experience with PeopleSoft Workforce Administration and Absence Management processes is also preferred.
• Experience administering comprehensive return-to-work, transitional work, disability management, occupational health, or fitness-for-duty programs.
• Experience collaborating with CSU third-party administrators, legal counsel, occupational health providers, and risk management professionals on complex and litigated claims. Experience developing and delivering management training related to workers' compensation, return-to-work obligations, disability management, workplace injury prevention, and regulatory compliance.
• Experience leading an integrated disability management, occupational health, or workforce health program within a complex organization

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