Technical Manager - Work Capacity & Entitlements (Self Insurance)
Core
Act as a subject matter expert to independently assess complex medical, vocational, and legislative information to determine work capacity, suitable employment, earnings capacity, and ongoing entitlement to weekly compensation benefits within a self-insured environment.
Role type
Senior Technical Specialist / Work Capacity Determiner
Builds
Evidence-based outcomes for workers compensation claims and entitlement decisions
Domain
Insurance / Workers Compensation / Self-Insurance
Required skills
Legislative interpretation, complex medical and vocational evidence analysis, dispute management, technical decision-making, stakeholder engagement, governance and compliance, process improvement
Preferred skills
Coaching and mentoring claims professionals, advanced analytical and critical thinking, written communication
Technologies
None explicitly stated
Responsibilities
Make complex work capacity and entitlement decisions ensuring legislative compliance; Analyse medical, vocational and factual evidence to determine outcomes; Manage reviews, disputes and escalated matters; Provide technical guidance, coaching and support to Claims Professionals; Maintain governance, quality assurance and compliance standards; Identify opportunities to improve processes and decision quality; Monitor trends, risks and emerging issues to support claims strategies.
Seniority
Senior, hands-on IC