Workers Compensation Case Manager

Lawrence Berkeley National Laboratory is seeking a Workers Compensation Case Manager who will serve as a pivotal link between Berkeley Lab Health Services Nurses, Berkeley Lab Integrated Disability staff, and the UC Third Party Administrator (TPA) managing Workers’ Compensation Cases. This role involves liaising between these parties to ensure efficient handling of cases. Additionally, the Case Manager supports the daily operations of the occupational health clinic by conducting medical surveillance exams and oversees the Berkeley Lab Wellness program. 

What You Will Do:

Workers’ Compensation Program:

• Coordinate with supervisors and department managers to ensure the prompt and accurate reporting of Workers’ Compensation claims, supporting timely reporting and appropriate benefit payments.
• Maintain verbal and written communication with Third Party Administrators, consultants, managers, medical providers, supervisors, and employees, ensuring timely claim filing and consistent case management.
• Enter and maintain incident, claim, and first aid data in appropriate information systems. Process all claim-related forms within legally required timeframes. Distribute all relevant documentation regarding work-related incidents to Safety, Health Services, and TPA to assist with compensability determinations and ensure regulatory requirements are met.
• Monitor all claim and case management activities on a daily basis. Assess the medical status, vocational, and behavioral needs of an injured employee via face-to-face, telephonic, and written correspondence.
• Participate in strategic planning aimed at reducing the incidence rate of Workers’ Compensation-related injuries and associated financial risks. Actively participate in safety and security committees and serve on accident review boards.
• Initiate leaves and coordinate the integration of pay with Workers’ Compensation disability plans.
• Develop and maintain injured worker case records to ensure compliance, accuracy, and documentation of efforts.
• Coordinate claim resolution with vocational rehabilitation counselors, medical specialists, Human Resources specialists, safety specialists, and divisions/departments.
• Administer Disability Management/Rehabilitation Meetings to discuss trends, recent ADA/FEHA court cases, Workers' Compensation updates impacting the provision of services to injured employees.

Clinic Function:

• Optimize employees’ health by conducting various medical surveillance exams, including medical and work histories, physical assessments, blood tests, audiograms, and pulmonary function tests.
• Perform Covid-related duties, such as contact tracing, in accordance with established protocols and guidelines.
• Identify real and potential health problems and hazards in the workplace through methods such as work-site surveys, toxicological literature research, and analysis of OSHA 200 logs and accident reports.
• Consult with other safety and health team members to improve occupational health practices and eliminate safety hazards.

Wellness Program:

• Act as the Subject Matter Expert (SME) for matters of Wellness and serve as the overall institutional "Owner" of the program at Berkeley Lab. Respond to inquiries from customers and consult with other Environmental Health and Safety (EHS) SMEs as required.
• Develop, implement, and monitor wellness goals in alignment with organizational objectives and employee needs. Ensure that wellness initiatives are evidence-based and tailored to the unique characteristics and requirements of Berkeley Lab.
• Maintain data and generate reports on wellness initiatives' effectiveness and impact. Provide regular updates to key stakeholders, including management and employees, to demonstrate the program's value and inform decision-making.

What is Required:

• Master of Science (M.S.) in Nursing and 5 to 7 years of relevant experience as a licensed registered nurse; or Bachelor of Science (B.S.) and 7 to 10 years of relevant experience as a licensed registered nurse.
• Alternatively, may be a graduate of an accredited Physician Assistant program and licensed as a Physician Assistant with NCCPA certification and/or COHN certification.
• Demonstrated work experience of state and federal disability laws, including ADA (Americans with Disabilities Act), FEHA (Fair Employment & Housing Act), FMLA (Family and Medical Leave Act), CFRA (California Family Rights Act), PDL (Pregnancy Disability Leave), and Workers' Compensation case/claims and case management.
• Basic working knowledge of Salary Continuance plans, including Statutory Disability, Short-term Disability, Long-term Disability, Sick Leave, Vacation, Paid Time-Off, and Workers’ Compensation.
• Intermediate knowledge of vocational rehabilitation and return-to-work principles, theories, and practices. Possess strong relevant consulting, counseling, case management, and communication skills.
• High competency in reviewing medical documentation, assessing disability leave duration, and conducting accommodation assessments.
• Solid technical understanding and background, broad expertise in nursing practice and clinical workflows, and strong organizational skills.
• Significant knowledge of professional concepts and theories pertaining to employee wellness, emergency preparedness, and technical expertise related to medical surveillance.
• Demonstrated strong collaborative and administrative capabilities. Knowledge of professional nursing principles with the ability to effectively and safely collaborate with less experienced clinical staff members, as well as more experienced team members.
• Evidence of immunity or declination of vaccination in accordance with OSHA Bloodborne Pathogen rule.
• Proficient with standard computer systems and applications in a professional business setting. Ability to utilize computer programs and software to analyze, document, and present data and information using Google Docs and Sheets.
• Certification or the ability/willingness to gain certification in spirometry, audiometry, and CPR, and other certification as determined by the Medical Director.
• Ability to travel as needed to attend meetings, receive medical education, and/or represent LBNL, in addition to providing occasional coverage in the evenings, weekends, or holidays.
• Ability to independently establish priorities, perform multiple projects simultaneously with short deadlines and frequent interruptions, and complete assignments to meet Lab objectives.
• Experience with electronic medical records.
• Licensed Registered Nurse in California.
• Ability to lift up to 50 lbs.

Desired Qualifications:

• Certification as an Occupational Health Nurse (COHN or COHN-S).
• Ability to utilize clinical expertise to help with configuration, testing, optimization, and implementing electronic medical records, and other clinical applications.

Notes:

• This is a full-time 3 year, term appointment with the possibility of extension or conversion to Career appointment based upon satisfactory job performance, continuing availability of funds and ongoing operational needs.
• The Workers Compensation Case Manager is expected to pay $144,900.00 to $177,108.00 annually, which fits within the full salary range of $128,808.00 to $217,356.00 for the H70.3- Occupational Health Pr Nurse position. Salary for this position will commensurate with the final candidate’s qualifications and experience, including skills, knowledge, relevant education, certifications, while also aligned with the internal peer leadership group.
• This position may be subject to a background check. Any convictions will be evaluated to determine if they directly relate to the responsibilities and requirements of the position. Having a conviction history will not automatically disqualify an applicant from being considered for employment.
• Work will be performed primarily on-site at Lawrence Berkeley National Lab, 1 Cyclotron Road, Berkeley, CA. Option to telework as business needs.

Learn About Us:

Berkeley Lab is a U.S. Department of Energy national laboratory managed by the University of California and designated a Federally Funded Research and Development Center. Located in the San Francisco Bay Area, we have a close relationship with UC Berkeley, as well as robust partnerships with other academic institutions and industries, including those in Silicon Valley. The Laboratory conducts world-class research that supports clean energy, a healthy planet, and solution-inspired discovery science. Berkeley Lab is defined by our deeply felt sense of stewardship, which we describe as a commitment to taking care of the Laboratory's research, people, and resources that are entrusted to us. Our values of team science, innovation, service, trust, and respect knit us together as a community. We practice these values and prioritize our principles of inclusion, diversity, equity, and accountability (IDEA) to build highly effective teams that produce world-class science and technology and where all individuals, regardless of their backgrounds, disciplines, and experiences, can thrive.

Working at Berkeley Lab has many rewards including a competitive compensation program, excellent health and welfare programs, a retirement program that is second to none, and outstanding development opportunities. To view information about the many rewards that are offered at Berkeley Lab- Click Here.

Berkeley Lab is an Equal Opportunity and Affirmative Action Employer. We heartily welcome applications from women, minorities, veterans, and all who would contribute to the Lab’s mission of leading scientific discovery, inclusion, and professionalism. In support of our diverse global community, all qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or protected veteran status. 

Equal Opportunity and IDEA Information Links: Know your rights, click here for the supplement: "Equal Employment Opportunity is the Law" and the Pay Transparency Nondiscrimination Provision under 41 CFR 60-1.40.