Metro’s mission is to provide a world-class transportation system that enhances the quality of life for all who live, work, and play within LA County. DescriptionManages and oversees the activities of one or more areas within Risk Management, including Workers? Compensation Claims Administration, General Liability Claims Administration, Investigations, and Risk Financing.
Examples of Duties- Manages and conducts complex planning, implementation, funding, and analytical projects and programs for Risk Management functions
- Supports executive management in the development and implementation of strategic objectives in assigned area
- Manages staff, consultants, and/or projects.
- Manages and oversees operational audits in assigned area
- Recommends investigations based on claim information, circumstances, etc.
- Ensures staffs understanding and strict compliance with all confidentiality provisions under relevant State of California Insurance Code, California Government Code, Labor Code, etc.
- Develops red flag assessment protocols for injury/illness occupational and general liability claims
- Supervises intensive data mining reviews of information related to injured workers to determine appropriateness of intensive investigation and surveillance requirements to combat workers? compensation fraud and abuse
- Organizes and provides guidance to risk management staff regarding complex investigations and case development in the area of claims management and accident collision investigations
- Responds to accident scenes and supervises, and reports back on incidents/accidents
- Analyzes trends and develops programs and other measures to reduce claims exposure
- Reports, summarizes, and communicates findings to appropriate area, level, or statutory reporting agency
- Participates in assessment of claims with County Counsel for concurrence before local government and state level reporting
- Investigates, adjusts, and manages claims caseload; settles claims in collaboration with affected Division staff and Counsel
- Works with appropriate prosecuting and law enforcement agencies including State of California Department of Insurance, State of California Fraud Division’s Anti-Fraud Programs, State of California Department of Industrial Relations Division of Workers? Compensation, and local District Attorney?s Offices
- Manages and/or conducts training for personnel and all other interested personnel with respect to risk management, including fraud awareness and recognition
- Prepares narrative, graphic, and statistical reports for executive and Board presentations, and internal review
- Develops policies and procedures for assigned area
- Supports all internal departments with risk management needs
- Partners and communicates with other departments to administer programs and achieve agency goals
- Recommends corrective action to resolve problems, abuses, and deficiencies that may exist
- Complies with Metro?s bill paying standards to ensure project and cost center invoices are paid in a timely manner
- Communicates and implements safety rules, policies, and procedures in support of the agency's safety vision and goals; and maintains accountability for the safety performance of all assigned employees
- Contributes to ensuring that the Equal Employment Opportunity (EEO) policies and programs of Metro are carried out
May be required to perform other related job duties
Minimum QualificationsA combination of education and/or experience that provides the required knowledge, skills, and abilities to perform the essential functions of the position. Additional experience, as outlined below, may be substituted for required education on a year-for-year basis. A typical combination includes:
Education- Bachelor's Degree in Public Administration, Business Administration, or a related field
Experience- Six years of relevant experience or three years of relevant supervisory-level experience in one or more risk management function such as workers’ compensation, general liability, risk financing, and/or investigations programs; some positions in this class may require specialized experience in area of assignment
Certifications/Licenses/Special Requirements- A valid California Class C Driver License or the ability to utilize an alternative method of transportation when needed to carry out job- related essential functions
- Certified Professional in Fraud Identification (CPFI), insurance fraud investigator, private investigator license, or law enforcement training in investigation preferred
- California Workers' Compensation Self-Insured Certificate preferred
Preferred Qualifications (PQs) are used to identify relevant knowledge, skills, and abilities (KSAs) as determined by business necessity. These criteria are considered preferred qualifications and are not intended to serve as minimum requirements for the position. PQs will help support selection decisions throughout the recruitment. In addition, applicants who possess these PQs will not automatically be selected.
The following are the preferred qualifications:
- Experience handling claims or investigations related to general liability, property casualty, auto-accident or workers’ compensation
- Experience identifying and reporting insurance fraud and working with state or local law enforcement prosecution offices
- Experience investigating traffic collisions, collision reconstruction, or related areas
- Experience leading or managing projects related to risk management
Essential KnowledgeKnowledge of (defined as a learned body of information that is required for and applied in the performance of job tasks)
- Theories, principles, and practices of workers’ compensation claims administration, general liability claims administration, risk financing, and investigations
- Applicable local, state, and federal laws, rules, and regulations governing insurance code, government code, labor code, criminal investigations, and risk financing
- Strategies and procedures of case settlements
- California Government Code and Rules of Civil Procedure and rules and practices of the local Superior and Municipal Courts
- Claims investigation protocols
- Personal injury analysis and evaluations, and wrongful death claims
- General and auto liability claims
- Elements of tort law
- Investigating claims and determining reasonable settlements
- Specialized investigative techniques, intelligence gathering, and examination methods
- Research and report preparation methods
- EEO and Affirmative Action rules and regulations
- Modern management theory
- Applicable business software applications
Skill in (defined as the proficient manual, verbal, or mental utilization of data, people, or things)
- Overseeing the operations of workers’ compensation, general liability, investigations, or risk financing program
- Exercising appropriate administrative recommendations and actions based on findings and developments
- Analyzing situations and identifying problems
- Preparing and reviewing comprehensive reports and correspondence
- Exercising sound judgment and creativity in making decisions Communicating effectively orally and in writing
- Interacting professionally with various levels of Metro employees, Office of Inspector General, other law enforcement and prosecutorial agencies, and various outside representatives
- Supervising, training, and motivating assigned staff
Ability to (defined as a present competence to perform an observable behavior or produce an observable result)
- Recognize sensitive issues and manage the activities of assigned staff accordingly
- Develop and promote positive working relations within the cabinet, other Metro departments, as well as with outside law enforcement and regulatory agencies
- Develop and deliver quality projects from inception to close-out, on time, and within scope and budget
- Meet tight time constraints and deadlines
- Think and act independently
- Understand, interpret, and apply laws, rules, regulations, policies, procedures, contracts, budgets, and labor/management agreements
- Compile and analyze data
- Conduct administrative and criminal investigations
- Represent Metro before the public
- Travel to offsite locations
- Read, write, speak, and understand English
Special ConditionsThe physical demands described are representative of those that must be met by the employee to successfully perform the essential functions of this job. Metro provides reasonable accommodation to enable individuals with disabilities to perform the essential functions.
Working Conditions- Typical office situation
- Close exposure to computer monitors and video screen
- Work irregular hours, split shifts, weekends, holidays, or 24-hour-a- day on-call assignments
- Work after designated regular hours in case of special assignments or emergencies
- Local travel
Physical Effort Required- Sitting at a desk or table
- Operate a telephone or other telecommunications device and communicate through the medium
- Type and use a keyboard and mouse to perform necessary computer-based functions
- Standing
- Walking(distance5'to100')
- Communicating through speech in the English language required
Metro is an Equal Opportunity Employer and does not discriminate on the basis of race, color, creed, ancestry, national origin, gender, marital status, sexual orientation, religion, age, veteran status, or disability. Learn more about Metro’s Equal Employment Opportunity Program . Metro does not deny participation in the application process to anyone with prior justice system involvement, in line with Fair Chance hiring practices.
Selection Procedure Applicants who best meet job-related qualifications will be invited to participate in the examination process that may consist of any combination of written, performance, or oral appraisal to further evaluate job-related experience, knowledge, skills and abilities.
Application Procedure To apply, visit Metro's website at www.metro.net and complete an online Employment Application.
Computers are available to complete online Employment Applications at the following Metro location:
METRO Headquarters, Employment Office
One Gateway Plaza
Los Angeles, CA 90012
Telephone: (213) 922-6217 or persons with hearing or speech impairments can use California Relay Service 711 to contact Metro.
All completed online Employment Applications must be received by 5:00 p.m. on the closing date.
*Open to the public and all Metro employees
This job bulletin is not to be construed as an exhaustive list of duties, responsibilities, or requirements. Employees may be required to perform other related job duties.
Closing Date/Time: 10/9/2024 5:00 PM Pacific
