Salary Range: $32.01 - $44.56 / hour

The pay range above represents the lowest possible rate for the position and the highest possible rate. Factors that may be used to determine where newly hired employees will be placed in the pay range include the employee specific skills and qualifications, relevant years of experience and comparison to other employees already in this role. Most often, a newly hired employee will be placed below the midpoint of the range. If you are viewing this posting on a job site, please visit our company page and search for the opportunity to view the pay range: https://careers-mycmh.icims.com/jobs

Reports to the Director of Occupational Health Services and is responsible for providing Workers' Compensation/disability and Loss prevention activities for Community Memorial Health System and its affiliates. Acts as a resource to the CMHS leadership team and employees regarding workers compensation. Coordinates activities between employees, supervisors, medical providers, third party administrators, legal counsel, Human Resources, Payroll and other agencies involved with leave of absences and California Workers Compensation. Assist with minimize the risk of job-related accidents and monitor operations to eliminate hazardous activities. Promote Occupational Health and Workers' Compensation safety awareness. Performs general administrative and office support duties on assigned projects and other work as necessary.

Essential Functions and Responsibilities:

Acts as a resource to the CMHS, leadership team, and employees regarding workers compensation guidelines, policies, and processes.
1. Identifies workers compensation claims requiring additional attention/escalation and initiates interventions to properly address the circumstances of the claim.
2. Provides proactive communication/education with managers and employees regarding workers compensation to include education on state and federal workers compensation legislation and policy interpretation.
3. Corresponds in a timely manner via telephone or electronically to supervisors, employees, physicians, medical clinics, investigators, legal counsel, and the third party administrator regarding workers compensation claims.
4. Prepares correspondence to be sent to employees as applicable and in accordance with policies.
5. Submits workers compensation and disability claims to the third part administrator within 3 business days and reviews them for completeness.
6. Utilizes a medical claims management approach with the guidance of the Occupational Health clinical team to coordinate medical treatment, return to work, and leave of absences related to worker's compensation.
7. Provides assistance and instruction to managers and supervisors regarding workers compensation leave of absence electronic tracking system.
8. Escalates difficult or sensitive medical industrial and non-industrial employment related issues to Human Resources and Occupational Health RN.
9. Ensures paid leaves, long term sick banks and transitional work banks are appropriately accessed. Assists employees with questions regarding workers compensation benefits and coordination of payroll benefits.
10. Maintains and edits payroll records for employees on workers compensation. Assure appropriate payroll information is communicated to the third party administrator and supervisors to establish appropriate payment of benefits.
11. Processes employee terminations, ensures checks are timely and processes additional termination documents as necessary
12. Performs related clerical duties such as filing, photocopying, and running errands as required to maintain department operations.
13. Participates in Occupational Health annual programs.
14. Facilitates workers compensation leave of absence approvals, return to work, transitional work, and job accommodation.
15. Ensures proper documentation has been completed by the employee, Human Resources Department, and Occupational Health and ensures electronic documentation systems are updated with appropriate statuses.
16. Keep records of work safety-related incidents and propose corrective actions.
17. Collaborate with managers to monitor compliance and identify safety issues.
18. Assist with COVID-19 calls and provides email communication for return to work process.
19. Performs duties as assigned.

Required:

• High School diploma or equivalent (GED)
• Five (5) years' experience in Workers' Compensation Claims Management
• Knowledge of State and Federal labor laws and regulations
• Three (3) years' experience in Human Resources or Occupational Health in an acute health care environment within the last five years
• Proficiency in Microsoft Word, Excel, Power Point and Outlook
• One (1) year experience in a medical or business office
• Bilingual (English/Spanish)

Preferred:

• Bachelor's Degree in Business Administration
• Ten (10) years' experience in Workers' Compensation Claims Management
• Five (5) years' experience in Human Resources or Occupational Health

When it comes to quality, we're 5 Star!

Community Memorial Health System was established in 2005 when Community Memorial Hospital in Ventura merged with Ojai Valley Community Hospital. It is comprised of these two hospitals along with a network of primary and specialty care health centers serving various communities across west Ventura County. Our health system is a community-owned, not-for-profit organization. As such, we are not backed by a corporate or government entity, nor do we answer to shareholders. We depend on - and answer to - the communities we serve.

Community Memorial Hospital - Ventura has been awarded a prestigious five-star rating by the Centers for Medicare & Medicaid Services (CMS)! This achievement represents thousands of people going the extra mile every day for our patients, and we are the ONLY hospital in Ventura County to earn this distinction!

Community Memorial Healthcare Benefits

To help heal, comfort, and promote health for the communities we serve, Community Memorial Healthcare takes care of our community of employees so our local community can be cared for. That's why we provide competitive benefits, along with great career choices, training, and leadership development. Our total rewards package provides benefits that support you and your family's health and wellness in all aspects of life. From our top tier insurance plans to our employee assistance program, take advantage of what CMH has to offer so you and your loved ones can have peace of mind now and for years to come. CMH is here for you and your family every step of the way.

• Competitive Pay
• Shift Differentials
• In-House Registry Rates
• Fidelity 403(b) Retirement Plan
• Paid Time Off
• Medical (EPO/PPO), Dental, & Vision Insurance Coverage
• Voluntary Worksite Benefits
• Employee Assistance Program Available 24/7 (EAP)
• Tuition Reimbursement
• Public Service Loan Forgiveness (PSLF)
• Recognition programs
• Employee service recognition events
• Home, Retail, Travel & Entertainment Discounts
• National Hospital Week and National Nurses Week celebrations

Community Memorial Healthcare is an equal opportunity employer to all, regardless of age, ancestry, color, disability (mental and physical), exercising the right to family care and medical leave, gender, gender expression, gender identity, genetic information, marital status, medical condition, military or veteran status, national origin, political affiliation, race, religious creed, sex (includes pregnancy, childbirth, breastfeeding and related medical conditions), and sexual orientation. We strive to promote an environment where exceptional people bring diverse perspectives and find belonging, support and connection to their work in our community.

"We are an AA/EEO/Veterans/Disabled Employer"