Full employer posting
At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network includes 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers, and thousands of physicians. Supported by more than 30,000 team members, we promote a forward-thinking philosophy built on trust, dignity, respect, responsibility, and clinical excellence.
The Workers Compensation Lead serves as the department’s subject matter expert on technical Workers’ Compensation claims and provides guidance to the Workers’ Compensation team on complex case management matters. This position manages an assigned caseload and oversees all aspects of the claims handling process to ensure injured team members have timely access to quality medical care and a safe and efficient return to work.
The Workers Compensation Lead also partners with Workers’ Compensation leadership on ongoing initiatives to enhance the effectiveness and quality of BayCare’s Workers’ Compensation program. This is a hybrid position requiring two days per week in the Clearwater office . Performs other duties as assigned.
Key Responsibilities Proactively manages all aspects of Workers’ Compensation claims, including claim investigation, return-to-work coordination, and medical case management. Implements standardized processes for recording, investigating, and reporting Workers’ Compensation claims. Conducts thorough accident and incident investigations to identify root causes.
Partners with the Third-Party Administrator (TPA) to facilitate timely and accurate compensability decisions. Ensures injured team members receive timely access to quality medical care and supports safe and efficient return-to-work plans. Reviews the quarterly safety assessment tool process and manages special reporting requests related to work-related injury data.
Supports quarterly forecasting and claims review processes. Serves as a subject matter expert on Workers’ Compensation and Occupational Safety and Health Administration (OSHA) regulations and helps ensure organizational policies and procedures are updated in response to regulatory changes. Supports vendor and attorney relationship management.
Completes first-level reviews of settlement requests and reserve increases. Represents the organization in Workers’ Compensation mediations and hearings. Ensures timely and accurate reporting, including first reports of injury and OSHA logs.
Maintains comprehensive documentation to support case management and regulatory compliance. Provides guidance, training, and ongoing support to the Workers’ Compensation team. Supports quality assurance efforts and provides recommendations regarding the use of external counsel, case management, and investigative services.
BayCare Values & Guiding Principles Demonstrates a consistent commitment to BayCare Health System’s core values of trust, respect, and dignity in interactions with patients, families, team members, and the community, supporting our shared responsibility to achieve excellence in the communities we serve. Upholds and models BayCare’s Guiding Principles by being present and curious; acknowledging and engaging others; listening, understanding, confirming, and taking thoughtful action; seeking and implementing solutions; honoring the humanity of every individual; and celebrating and appreciating the contributions of others.
Education Associate’s degree in Healthcare or a related field required. Bachelor’s degree in Human Resources, Business Administration, Risk Management/Insurance, Healthcare Administration, or a related field preferred. Required Licensure, Certification, or Experience In addition to the required education, candidates must meet at least one of the following: Workers’ Compensation Adjuster license; or Registered Nurse (RN) or Licensed Practical Nurse (LPN) license with Case Manager certification; or Experience in a Workers’ Compensation Specialist role with a large employer or Workers’ Compensation physician practice.
Required Experience & Knowledge Minimum of 7 years of experience in Workers’ Compensation, case management, and Workers’ Compensation litigation strategies . Knowledge of regulatory requirements and statutes related to Workers’ Compensation, including OSHA, HIPAA, ADA, FMLA, Medicare, and Social Security . Position Details Facility: BayCare Health System, Workers Compensation-BCHS Location: BayCare System Office East Status: Full Time, Exempt
8:00 a.m. - 4:00 p.m.
Days Weekend Work: Occasional On Call: No Work Arrangement: Hybrid, with two days per week required in the Clearwater office BayCare is an Equal Opportunity Employer. Veterans/Disabled.
About the role
The Workers Compensation Lead serves as the department’s subject matter expert on technical Workers’ Compensation claims and provides guidance to the Workers’ Compensation team on complex case management matters.