Workers Comp Clinical State Manager

Ivy Rehab • $80K — $95K *

Philadelphia, PA 19120In-Person

Healthcare

5 - 7 years of experience

Today

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Job Overview by Ladders

Qualifications

Bachelor's Degree or equivalent business experience
Clinical degree in Occupational Therapy or Physical Therapy
Minimum 5 years in WC claims and/or legal experience; supervisory experience preferred
Willingness and ability to travel up to 25%
Strong focus on ownership and accountability
Exceptional communication and interpersonal skills
Outstanding time management abilities

Responsibilities

Support development and management of workers' compensation program oversight
Formulate and oversee strategies for business objectives
Build relationships to enhance claims handling performance
Manage claims proactively to ensure prompt resolutions
Direct Third Party Administrators and nurture relationships
Analyze business objectives, including claim trends and recovery opportunities
Assist with workers' compensation utilization review and audits

Benefits

Remote work option for candidates in EST/CST
Opportunity for business travel
Mentoring and coaching opportunities for professional development
Involvement in community and stakeholder networking events
Access to ongoing training and workshops
Exposure to diverse operational functions and cross-functional teamwork

Full Job Description

State of Location:
Pennsylvania

Position Summary:

The Workers' Comp Clinical State Manager will report to the Director of Workers' Compensation and be a member of Ivy's Workers' Comp Department Team. The successful candidate will support the development, maintenance, and management of Ivy Rehab's workers' compensation program oversight specific state.

This position has the opportunity to work remotely to candidates in based in EST/CST and will require some travel for business meetings.

Your responsibilities will include:

Perform responsibilities under general and direct supervision of Director of

Workers' Compensation Operations.

Perform assignments, tasks or activities that contribute to the overall workers' compensation business objectives of the corporation and the business divisions being supported and formulating strategies to achieve those objectives.

Overseeing the implementation of those strategies.

Develop and maintain strong relationships with both external and internal customers to increase productivity with a focus on achieving claims handling excellence

Maintain proactive management of claims by focusing efforts toward expedient and equitable resolutions

Provide timely and appropriate direction and authority to assigned Third Party Administrators; establishing strong relations

Perform assignments, tasks or activities that contribute to the overall objectives of the business division being supported including but not limited to; claim investigations, settlements, and litigation

Work cross functionally in a team environment consisting of compliance, legal, IT, raintree support, front desk operations, revenue cycle, and finance.

Ensure all recovery opportunities are investigated and explored

Drive Workers' Comp KPI Metrics, including but not limited to Workers' Comp Visits, New Patients, LOS, SFQ, coding accuracy for PT/OT and Work conditioning payor mix, functional capacity evaluations, SSG planning, and other industrial specialty services.

Assist with workers' compensation utilization review process management including but not limited to chart audit, peer review, bill review

Identify trends to determine business weaknesses and develop action plans to correct negative trends and establish monitoring method to ensure action plans have been successfully implemented

Responsible for implementation, monitoring and reporting on results of assigned special projects nurse case manager CEUs, social media blogs, workers' comp networking/conference activities, and integration/companywide trainings.

Responsible for oversight of regional champions and working with regional directors to ensure we have the appropriate teammate. Provide ongoing mentoring and coaching opportunities to regional champions to optimize workers' compensation business objectives. Facilitate oversight of biweekly agenda driven regional champion meetings.

Respond to workers' comp distribution list to provide clinical support, clinical note

audits, education, improve raintree efficiencies to field teammate support and communication.

Review documentation of new hires & integration partners to ensure best practice documentation and clean claims process is being promoted.

Provide clinical support and resolution for claims management to the organization.

Provide workers' compensation quarterly in-services for clinical teammates.

Meet quarterly with RD, AD, RWCC, revenue cycle teammates, and business development teams to share results, highlight successes, and align with operational action plans to improve business objectives.

Work collaborative with business developmental team to assist with community and stakeholder networking events to market and brand workers' comp service line.

Assist with integration and new hire clinical training for comprehensive clinical care program and documentation system.

Mentor regional champions for professional development on clinical ladders expert/advanced skills to expand clinical services offered in adult orthopedic offices.

To excel in this role, you should possess:

Bachelor's Degree or equivalent business experience

Clinical degree in Occupational Therapy or Physical Therapy

Minimum 5 years of experience in WC claims and/or legal experience; supervisory experience a plus

Willingness and ability to travel up to 25% of the time

Ownership/results/accountability-oriented, able to overcome obstacles

Ability to work in a fast-paced environment while maintaining a positive attitude

Self-motivated with the willingness and commitment to exceed expectations, learn and professionally grow

Exceptional written and verbal communication, presentation, and interpersonal skills

Outstanding time management skills and ability to manage multiple tasks and assignments in a changing environment with competing projects

Ability to maintain strict confidentiality

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Actual salaries depend on a variety of factors, including experience, specialty, education, and organizational need. Any listed salary range or contractual rate does not include bonuses/incentive, differential pay, or other forms of compensation or benefits.

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There has never been a better time to join the dynamic team at Ivy Rehab—the leading network of therapy providers dedicated to enhancing physical performance and wellness.

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Join Ivy Rehab's top-tier team to assist individuals in overcoming physical challenges and achieving personal health goals. At Ivy Rehab, the focus is on leveraging innovation in therapy to transform patient care and wellness practices. Lead in a unique role within the healthcare industry, at the crossroads of clinical expertise, leadership, and innovative health solutions. Engage with a professional team of healthcare specialists to guide patients through their rehabilitation journey. Collaborate with the most skilled therapists and healthcare professionals in the industry, dedicated to advancing physical therapy and patient care.

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