If you’re passionate about helping people protect what matters most to them, as well as innovating and simplifying processes and operations to provide the best customer value, then Nationwide’s Property and Casualty team could be the place for you!

Territory: The location of this position is flexible and open to virtual and/or remote based applicants.

#LI-BC1

Job Description Summary

Responsible for the direct handling of the most complex and high exposure claims, including both litigated and non-litigated losses. Technical expert for claims $500,000 and above or where complex coverage, risk drivers and employee profile and severity losses as requested regardless of dollar exposure. On site participation in mediation or negotiations may be required. Manages the activities of defense counsel to expedite settlement and to control average loss cost and litigation expense. Responsible for the disposition of claims in accordance with prescribed authority. Contact with external customers which involves maintaining, developing and influencing relationships with major customers or key individuals. Partners with field director and core teams, providing mentorship and special project oversight, where requested.

Job Description

Key Responsibilities:

• Manages the delivery of timely and accurate WC benefits on new, catastrophic losses and developed large loss claims; Large loss claims are defined by pure exposure exceeding $500,000 or claims that include risk drivers/employee profile triggers requiring escalation to LL Team.

• Provides reserve analysis to ensure timely and accurate case reserves in accordance with Best Claims Practices.

• Creates large loss notifications, claim analysis reports, reinsurance reports, and other information to home office, claims management, underwriting, and product.

• Leads or serves on various project teams as assigned based on business need. Assists Underwriting and Product in the review and development of new or existing policy language.

• Partner with field operations in strategy discussions on losses that are below large loss thresholds; Active participation in roundtable process with core teams.

• Provides advice, counsel, and training to Field Operations. Recommends various methods of dispute resolution and settlement in those cases where warranted.

• Ensure all statutory and regulatory requirements are met.

• Acts as a subject matter expert within the national operation; Provide expertise in implementing claim initiatives and other projects as assigned.

• Drives appropriate utilization of vendor partners to achieve cost effective claim outcomes, including catastrophic case management vendors, where appropriate

• Maintains high level contact with our business partners to support revenue retention efforts; Partners closely with field directors to provide actional personnel feedback related to reassigned case findings.

May perform other responsibilities as assigned.

Reporting Relationships: Reports to Manager, Claims-Workers Comp Lg Loss. No direct reports.

Typical Skills and Experiences:

Education: Undergraduate studies in business administration or related field preferred and/or relevant Workers Compensation experience

License/Certification/Designation: State licensing where required. Successful completion of required/applicable claims certification training/classes.

Experience: Eight years workers' compensation claims experience. Prior high exposure claims handling experience; Prior handling of complex, multi-jurisdictional claims.

Knowledge, Abilities and Skills: Proven superior knowledge of best claims practices used in managing the administration and resolution of the most serious and complex bodily injury and resolution of complex claims. Technical expertise in multiple jurisdictions, with enhanced skills at managing complex medical or resolving challenging claims. Requires proven knowledge of workers' compensation insurance operations, field and staff functions, industry trends, and project management. Proven knowledge of insurance contracts, medical terminology and legal aspects of court procedures affecting legal exposures for workers' compensation. Proven ability to meet customer needs and provide exemplary service by informing customers of the claims process and ensuring a positive customer experience. Demonstrated decision-making and analytical skills. Strong verbal and written communication skills and the ability to communicate with field leadership, staff management and other departments. Ability to provide a multi-jurisdictional analysis of coverage, compensability and benefits. Provides oversight and analysis regarding the selection and direction of defense counsel in cases involving serious and complex compensability/injury issues from inception through resolution. Organizational skills to effectively establish work priorities in accordance with objectives and standards. Ability to operate various claims systems and related software.

Other criteria, including leadership skills, competencies and experiences may take precedence.

Staffing exceptions to the above must be approved by the hiring manager’s leader and HR Business Partner.

Values: Regularly and consistently demonstrates the Nationwide Values.

Job Conditions:

Overtime Eligibility: Exempt (Not Eligible)

Working Conditions: Normal office environment. Normal office environment. May require ability to sit and use telephone and personal computer for extended periods of time. Must be willing to work irregular hours and to travel with possible overnight requirements. Must be available to work catastrophes (CAT) requiring travel to CAT site with multiple on-site responsibilities and/or for extended periods of time. Extended and/or non-standard hours as required.

ADA: The above statements cover what are generally believed to be principal and essential functions of this job. Specific circumstances may allow or require some people assigned to the job to perform a somewhat different combination of duties.

Credit/Background Check: Due to the fiduciary accountabilities within this job, a valid credit check and/or background check will be required as part of the selection process.

We currently anticipate accepting applications until 03/28/2024. However, we encourage early submissions, as the posting may close sooner if a strong candidate slate is identified before the deadline.

Benefits

We have an array of benefits to fit your needs, including: medical/dental/vision, life insurance, short and long term disability coverage, paid time off with newly hired associates receiving a minimum of 18 days paid time off each full calendar year pro-rated quarterly based on hire date, nine paid holidays, 8 hours of Lifetime paid time off, 8 hours of Unity Day paid time off, 401(k) with company match, company-paid pension plan, business casual attire, and more. To learn more about the benefits we offer, click here.

Nationwide is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive culture where everyone feels challenged, appreciated, respected and engaged. Nationwide prohibits discrimination and harassment and affords equal employment opportunities to employees and applicants without regard to any characteristic (or classification) protected by applicable law.

This position could be filled within any of the lower 48 U.S. states.

#claims

Smoke-Free Iowa Statement: Nationwide Mutual Insurance Company, its affiliates and subsidiaries comply with the Iowa Smokefree Air Act. Smoking is prohibited in all enclosed areas on or around company premises as well as company issued vehicles. The company offers designated smoking areas in which smoking is permitted at each individual location. The Act prohibits retaliation for reporting complaints or violations. For more information on the Iowa Smokefree Air Act, individuals may contact the Smokefree Air Act Helpline at 888-944-2247.

For NY residents please review the following state law information: Notice of Employee Rights, Protections, and Obligations LS740 (ny.gov) https://dol.ny.gov/system/files/documents/2022/02/ls740_1.pdf

Nationwide pays on a geographic-specific salary structure and placement within the actual starting salary range for this position will be determined by a number of factors including the skills, education, training, credentials and experience of the candidate; the scope, complexity and location of the role as well as the cost of labor in the market; and other conditions of employment. If a Sales job, Sales Incentives, based on performance goals are possible in addition to this range.

The national salary range for Consultant, Claims - Workers Compensation Large Loss : $93,000.00-$192,000.00

The expected starting salary range for Consultant, Claims - Workers Compensation Large Loss : $103,000.00 - $155,000.00