Manager Management
Resume:
Ramunas (Ray) Vidziunas
Chesterland, OH 44026
abmi13@r.postjobfree.com
OBJECTIVE
A position with a progressive organization in which to independently adjudicate moderate to highly complex
occupational illness and survivor claims filed under state workers compensation laws; examine illness and
survivor cases for factual and medical sufficiency and legal correctness in order to reach a full and final claim
resolution with a minimum exposure to the company.
CORE SUMMARY
Management professional with extensive workers compensation, disability management and occupational
medicine experience. Strong leadership abilities and work ethic. Capable of providing excellent customer
service and skilled in problem solving. Acknowledged for teaching and training abilities. Self-motivated and
detailed oriented; can work well independently or as a cooperative team member
WORK EXPERIENCE
Constitution State Services-St. Paul Travelers, Inc., Independence, OH – November, 2005 –
July, 2008
Return to Work Case Manager/Critical Care Unit
Produce a high quality work product on intermediate to complex claims through immediate contact and the
effective investigation, reserving and adjustment of claims incurred by clients. Analyze First Report of Injury
to determine nature of loss, coverage provided, compensability and scope of injury. Conduct investigations
of all aspects of reported claims. Establish accurate and timely reserves. Maintain an active diary to monitor
timely development of the file and timely disposition of the claims. Promptly and properly document all
developments in claim file. Effectively negotiate compromise settlements where appropriate. Recognize
and pursue subrogation where applicable. Clearly communicates with all internal/external customers.
Monthly manages an average of 140 active lost-time claims. Work as a co-adjuster in the Critical Care unit
for more complex claims, such as: injuries that are serious or catastrophic in nature; Review and approve
medical bills to be paid under Ohio’s usual and customary fee schedule. Conducts quarterly and annual
claim audits with national accounts. Team leader for Nurse Case Manager and Medical Only claims. Some
accomplishments include:
• Pro-active claim and disability management facilitated return to full work or in a modified fashion in 91% of
assigned lost time claims
• Saved thousands of dollars for national clients by pursuing inactive, closed claims to reach a permanent
disposition and permit the client to close their financial responsibility in states where they no longer operate in.
• Negotiated full and final settlements, including client’s obligations under the Medicare Secondary Payer Act, all
within 30% to 40% of the total scope of authority.
• Exceeded 95% outside performance management rating on cost containment strategies for defense
counsel, medical case management, surveillance and other vendors.
.
Cleveland Construction, Inc., Mentor, OH – November, 2002 to November, 2005
National Workers' Compensation Administrator
Administer the National, the Ohio State Fund and Ohio self-insured workers compensation programs for this
commercial
construction company and its’ subsidiaries. Provide authorization and directs activities of third party administrator,
broker, outside investigators and legal counsel. Apply case management skills designated to mitigate losses and
equitably resolve litigation with a final settlement. Work with various third party administrators on multi-jurisdictional
settings. Develop Return to Work policies with National Safety Director for all federal and state job sites. Coordinate
Cleveland Construction’s health/benefit program, including claims filed for short and long term disability. Conducted
semi-annual claim audits with TPA administrator .
• Demonstrated proactive claim management resulted in the company’s NCCI Experience Modification
Factor
to be equal to or less than 1.0, resulting in significant savings for insurance premiums on multi-million job
contract bids.
Page 2 Ramunas Vidziunas
• Developed, administered and trained senior management and all employees on the company's Drug Free
Workplace Program, which assisted in the reduction of work injury claims by 10%.
• In 2005, panel speaker at the Ohio Bureau of Workers Compensation Bureau annual Workers Compensation
University program; speaking on self-insured self-administered programs.
• Created weekly, bi-weekly and monthly wage calculation and benefit entitlement calculator using Microsoft
Excel spreadsheet.
Kaiser Foundation Health Plan, Cleveland, OH
-1995 to 2002
Sr. Sales Executive 2001-2002
Manager of Occupational Medicine 1996-2001
Claims & Services Supervisor 1995-1996
Establish new marketing plan and related collateral for Kaiser On-The-Job Occupational Health Services, which
was the fee-for-service occupational health program. Serve as the occupational health services program manager
for 275 medical providers, 10 medical office buildings. and 2 emergency departments in a HMO managed care
setting. Provide workers' compensation consulting services to the Ohio Permanente Medical group, 2400 private,
public and federal employers. Supervise assigned personnel; performed competency outcome assessments,
performance appraisal and provided educational support for attracting and retaining talent with a budget of
$500,000 dollars. Work with HR department to develop Return to Work policies and guidelines, which incorporated
organizations’ national union contracts. Administer the self-insured workers' compensation program and Qualified
Health Plan (QHP – implemented medical provider network for treatment of injured workers)
• Developed regional marketing collateral for the occupation health program, stimulating employer group interest
in occupational injury care.
• Working with third party administrator, the organization's workers compensation costs were reduced from
$900,000 dollars down to $300,000 dollars per year.
• Reduced the occupational medicine billing backlog from 2 years down to 180 days, increasing average
yearly revenue by $250,000 for organization.
• Created revenue enhancement policy and procedures to identify work injury treatment visits, resulting in a
backlog reduction from 8,200 visits to 1,100 visits, which subsequently increased billable services.
• Developed business venture for an Occupational Health Clinic within HMO setting (fee for service
program).
EDUCATION
BA, Southern Illinois University, Carbondale, MA, Southern Illinois University, Carbondale, IL
Concentration in Human Resource Management, Illinois Benedictine College; Paralegal certification for
Business Law, Roosevelt University; Illinois Institute of Continuing Legal Education series on Employment
Termination, Recruitment, EEO/Discrimination, Benefits
TECHNICAL TRAINING
Numerous management programs, conferences and seminars, e.g., Workers' Compensation, Integrated Disability
Management, Drug Testing, FMLA, MCO and Qualified Health Plan development, Marketing and Financial
Accounting. Participated in 60 hours of employer sponsored training: Medical Terminology, WC: Medical Strategies,
WC Fundamentals, Industry Best Practices, Financial Reserving, Head Trauma and related treatment, Negotiation
Skills, Use of Surveillance..
TECHNICAL SKILLS - Windows XP, Windows 7, Microsoft Office 2003 & 2007, Per Datum, TMATE – Claim
Management System
ORGANIZATIONS - Previous member of the Self-Insured Group of Ohio, former member of the SIGO Board
of Directors(2005) and prior member of the Disability Management Employers Council (DMEC) of Ohio.
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