10+ years of workers' compensation claims management experience
Strong expertise in Pennsylvania workers' compensation claims
Experience managing complex, disputed, and high-exposure claims
Proficient in medical claims management and investigation
Experience overseeing a third-party administrator or claims professionals
Collaborative experience with outside counsel on litigated claims
Ability to independently evaluate claim strategies and medical information
Responsibilities
Oversee a high-volume workers' compensation claims program focusing on Pennsylvania and Michigan claims
Evaluate complex and disputed claims, including compensability and settlement recommendations
Direct the TPA for proactive claims handling and timely resolutions
Review medical information and coordinate with occupational health professionals
Collaborate with outside counsel to establish strategies for contested claims
Analyze claims data to identify trends and recommend program improvements
Partner with Safety and Occupational Health on investigations and return-to-work opportunities
Benefits
Ownership of an established workers' compensation program
Access to on-site occupational health resources
Opportunity to influence program improvements
Planned transition with the incumbent for knowledge transfer
Hands-on claims expertise combined with broader program ownership
Full Job Description
Location: Hatfield, PA Work Arrangement: On-site Travel: Approximately 10%
Clemens Food Group seeks an experienced Workers' Compensation Claims Manager to own our workers' compensation claims program and strengthen how we manage complex claims, medical issues, and overall program performance.
This is an opportunity for a seasoned claims professional who enjoys getting into the details, making informed decisions, challenging the status quo when appropriate, and improving outcomes.
You will work closely with our third-party administrator (TPA), outside counsel, Safety, Occupational Health, Finance, and partners across the business. You'll also have access to on-site occupational health resources and the opportunity to influence how an established workers' compensation program continues to evolve.
What You'll Do
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.
What Success Looks Like
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 May Be a Strong Fit If...
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.
Qualifications
Required
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.
Experience in a self-insured, high-deductible, or significant retained-risk environment.
Subrogation experience.
Skills & Mindset
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.
Why This Opportunity Stands Out
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.
