Workers Compensation

MICHELLE ANN GILLETTE

**** *. ****** **** *********, CA 562-***-**** **********@*****.***

CAREER OBJECTIVE

A dynamic and accomplished professional with specialized experience in workers' compensation, disability management, and workplace safety in search of an opportunity to lead within a thriving organization.

PROFESSIONAL EXPERIENCE & ACCOMPLISHMENTS

SOUTHERN CALIFORNIA PHYSICIAN MEDICAL GROUP (SCPMG-KAISER) Disability Claims Supervisor, Disability Management, May 2019 to Present Supervised the disability leaves team day-to-day operations which included processing leave of absence request, counseling physicians and conducting the ADA reasonable accommodation/interactive process. Mentored and motivated the leave staff which consisted of three Leave Processing Specialist and a contract employee. Provided high quality and cost effective management to help identify and resolve issues of strategic importance. Drove the process workflow and made changes to policy & procedures where needed. Conducted high level audits to ensure compliance with process and procedures, FMLA/CFRA/PDL, as well as, payroll processes. Managed the high-level cases to drive towards a quick and amicable resolution. Trained staff and partnered with physician relations/shared services/payroll to meet our shared goals. Addressed training deficiencies and partnered with payroll to address workflow issues.

SOUTHERN CALIFORNIA GAS COMPANY, LOS ANGELES, CA

Compliance & Training Administrator, November 2013- May 2019 Responsible for auditing So Cal Gas and SDGE workers' compensation and non-occupational cases to ensure compliance with the California labor code, FMLA/CFRA/PDL, & ADA interactive processes and in accordance with the Employee Care Services process/procedures. Responsible for reviewing major reserve changes, settlement recommendations and secondary review of claim denials. Responsible for proactively managing claims, providing guidance and direction on claims handling. Responsible for developing training content for ECS personnel on a weekly basis and managers/supervisors annually. Responsible for mentoring and developing staff in conjunction with the ECS supervisor/manager. Responsible for monitoring regulatory changes and audit requirements. Responsible for validating OSHA reporting requirements. Monitoring and maintaining the monthly statistics for management to gauge performance. Completed the annual workers’ compensation self-insurer’s report and the excess renewal application. Job duties also include research/analysis of complex issues and special projects upon requests. Working in collaboration with the workers’ compensation claims we reduced our claims count by 20% in 2017 and reduced the outstanding IMRs to 0%. Temporarily supervised the Leaves Team for 6 months in 2015. Recognized by the HR department for participating in negotiations to resolve VA lien which resulted in $1.6 million dollars in savings for the company and another $95K in savings on the bill review.

CITY OF ESCONDIDO, ESCONDIDO, CA

Sr. Human Resources Analyst, November 2011 - September 5, 2013 Responsible for the professional duties related to the City’s self –insured workers' compensation program. Responsible for evaluating the work of the third party administrator handling the workers’ compensation claims. Handled day-to-day issues with employees concerning a workers’ compensation claim, benefit issues, return to work and/or ADA reasonable accommodation issues. Provided training and consultation to department managers regarding employees with workers’ compensation claims, leaves of absence issues, and the interactive process. Responsible for planning the annual budget for the workers' compensation program, the yearly OSHA reporting requirement, overseeing the city’s custom medical provider network and the annual self-insured employer’s report. Responsible for drafting request for proposals, recommendations to City Council, workers’ compensation settlement recommendations for the City Attorney and PERS disability retirements request for the City Council CITY OF ESCONDIDO, ESCONDIDO, CA

Benefits Analyst May 2011-November 2011

Responsible for the professional duties of the employee benefit/CalPERS retirement and non- occupational leave of absence program. Research and analyze various benefits plans and provide census information for broker on record. Maintain benefit contracts and information. Draft request for proposals and recommendations for City Council approval. Supervise the work of the benefits coordinator. Prepare benefit materials for health insurance committee and coordinate the open enrollment process. Worked with information technology to update Oracle system in preparation for annual open enrollment and/or critical plan changes. Served as the designated HIPPA officer providing training to internal staff and maintaining training records. Provided guidance to employees regarding the benefit program and PERS retirement. Successfully coordinated the 2011 open enrollment and City Health Fair for employees.

CALIFORNIA SUPERIOR COURT OF ORANGE COUNTY, SANTA ANA, CA Employee Benefits & Disability Management Officer (Sr. HR Analyst) July 2008-December 2009 Managed the employee benefits, workers' compensation, leave of absence, and ADA reasonable accommodation programs under the integrated disability management program. Supervised three Sr. Human Resource Specialist who were responsible for coordinating day-to-day claims processing and leave of absence requests. Responsible for managing the work of the third party administrator handling workers’ compensation claims. Provided feedback on claim direction and gave settlement authority within range of authority. Provided training to Managers on how to effectively manage workers’ compensation claimants, leave of absence and return to work issues. Also responsible for all ADA reasonable accommodation requests and conducting the interactive process. Responsible for leading the new benefit program project due to court pending separation from County. Planning for this change included gathering census information, researching benefit options and negotiating rate options with broker. Resolved complex benefit issues, developed benefit communication materials and coordinated open enrollment. Also responsible for developing and mentoring staff and performing annual appraisals.

AMERICAN GOLF CORPORATION, SANTA MONICA, CA

Sr. Safety & Workers' Compensation Manager, May 2006- July 2008 Managed the multi-state high deductible workers' compensation program, return to work, and corporate safety programs. Managed the third party administrator responsible for the claims handling process. Managed the direction of claims, monitoring reserve levels and providing settlement authority. Managed a staff of two, a workers’ compensation coordinating responsible for claims intake/set-up and Injury Counselor. Collaborated with Corporate Finance to conduct cost analysis, renewals and other financial insurance related issues. Conducted risk assessment studies and implemented corrective action. Promoted corporate safety strategies and conducted annual safety audits for 180 golf courses and country clubs across the US. Provided training to general managers regarding AGC Workers' Compensation Program. Conducted safety walk- thru inspections and responded to OSHA complaints and/ or violations. Managed injury/ illness prevention program and developed safety training programs for field employees. Also, responsible for developing safety training and maintaining training records as required by OSHA. Successfully rolled out the “Think Safety” campaign for the company nationwide. CITY OF COSTA MESA, COSTA MESA, CA

Risk Management Analyst, 2001-2006

Responsible for the administration of the City's self-insured workers' compensation program, employee benefits, leave of absence, reasonable accommodations and retirement programs. Monitored all workers' compensation claims handling process and procedures from beginning to end (claim resolution/ settlement). Coordinated the return to work/ reasonable accommodation/ leave of absence processes and provided regular status to HR/ Risk team. Administered the section 125 cafeteria benefit plan and PERS retirement program.

EDUCATION

BA in Journalism, California State University Northridge, 1996 CERTIFICATION

CA Self-Insurance Administrator's Certificate 2004 Workers' Compensation Claims Administrator's Certificate 2003 (WCCA) Passed ARM 54 Essentials of Risk Management exam

ADDITIONAL SKILLS

· Expert in Microsoft Office Suite

· Experience utilizing Oracle, HRIS ADP, Kronos, and various risk management programs including iVOS

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