Closing Date: 5th December, 2025
Description:
For approximately two weeks following hire, selected candidate will report to our Folsom office daily for training and onboarding. After successful completion, selected candidates will have the option to work full time in our Folsom office, or remotely from a home location within a commutable distance from our Folsom, CA office, or a hybrid of both options. Candidates must be able and willing to report in person to our Folsom location when required which is generally 4-6 times per month, but could change based on business needs.This position is open until filled, with a first review of applications occurring on Monday, October 27th, and tentative interviews scheduled for the week of November 3 or November 10, 2025.
PRISM is a joint powers authority (JPA) that provides risk management and insurance solutions for public entities throughout California. Our organization is member driven meaning that our public entity members have numerous opportunities available to participate in the governance of our JPA.
The Workers' Compensation (WC) Attorney is responsible for managing and resolving complex workers' compensation claims with a strategic focus on mitigating exposure and ensuring fair and cost-effective resolutions for all parties. This role involves developing settlement strategies, direct handling of settlement negotiations and collaborating with the claims adjusters, PRISM specialists, legal teams and other stakeholders to ensure claims are resolved in a timely and efficient manner that benefits the injured worker, the employer and the PRISM Programs in a fair and equitable approach.
Additionally, the WC Attorney will be responsible for providing training and guidance to PRISM and TPA staff, as well as our members, on claims processes, best practices and strategies for reducing overall claims costs.
The WC Attorney will also assist PRISM's in-house employment law legal department with member questions surrounding workers' compensation laws and processes.
Essential Functions/Key Responsibilities:
Claims Management and Resolution
- Evaluate Complex Claims: Assess cases thoroughly to identify potential risks and develop settlement strategies that are cost-effective and legally sound.
- Settlement Negotiations: Lead negotiations with injured employees, attorneys, claims administrators, employers and other representatives to achieve fair and efficient settlement agreements.
- Claim Investigations: Conduct thorough analysis on claims, reviewing medical records, legal documents, and other relevant materials to make informed settlement decisions.
- Liaison Role: Serve as a liaison between various stakeholders, including injured employees, attorneys, adjusters, and other claims professionals, to facilitate clear communication and expedite the resolution process.
- Documentation and Compliance: Ensure all settlements are documented accurately, maintaining compliance with state and federal laws and organizational guidelines.
- Risk Analysis and Strategy Development: Regularly review claims to identify early intervention opportunities and implement strategies to reduce financial exposure.
- Financial Analysis: Evaluate the financial impact of claims and settlements, including future medical expenses and indemnity, to ensure reserves are accurately set per OSIP standards.
- Loss Prevention Initiatives: Partner with the risk management team to identify trends and contribute to initiatives aimed at reducing claim frequency and severity.
- Worker's Compensation Act: Be proficient in all aspects of the WC Act, including the California Labor Code and Regulations, case law, claims handling practices, etc.
- Legal Advice: Assist the legal department with member questions surrounding workers' compensation laws and regulations. This may be in conjunction with overlapping employment law or leave questions.
- Staff Training: Develop and deliver training programs for the TPA Claims Adjusters, PRISM Specialists and other relevant staff on claims management, settlement negotiation and best practices.
- Member Training and Education: Provide guidance and training to members (e.g., employers or stakeholders within the workers' compensation program) on handling claims, preventing fraudulent claims, and mitigating workers' compensation costs by early resolution and settlement.
- Resource Development: Create training materials, guides, and presentations on various topics related to workers' compensation claims, settlement processes and risk management.
- Mentorship: Mentor and support new PRISM staff and when applicable, TPA Claims Adjusters in handling complex cases, sharing insights from more challenging claims and improving overall settlement skills within the team.
- Travel: Must have the ability to drive and maintain a valid California Driver's License and to travel as needed to perform functions of position.
Reporting and Analytics
- Claims Reporting: Generate and analyze settlement reports to track and monitor performance metrics, settlement trends and claims outcomes.
- Trend Analysis: Identify patterns in claims that contribute to cost drivers and recommend proactive measures to reduce long-term claims liabilities.
- Management Reports: Prepare monthly and quarterly reports for senior management that detail claim settlements, cost savings achieved, and strategic initiatives undertaken to mitigate exposure.
- Continuous Improvement: Use analytics to identify areas for process improvement within claims handling, settlement negotiation and staff training practices.
Education, Certification, Certificates, Knowledge & Experience:
Education and Experience Requirements Listed Are Minimum Standards. Other Equivalent Combinations of Education, Certifications, Training, and Experience May Be Considered.
Education: Juris Doctor (j.D.)
Minimum Required Knowledge and Experience: (temporary Modifications to Provide Reasonable Accommodations, or Transitional Work Assignments, Do Not Waive Any of The Essential Functions for This Position.)
- 10 or More Years' Experience in Providing Advice and Counsel in Workers' Compensation Law with At Least Five Years Providing Advice to Public Entities;
- Proven Track Record in Negotiating Claim Settlements and Navigating Litigation Processes;
- Solid, Working Knowledge and Understanding of California Workers' Compensation Laws, Including Case Law;
- Experience Providing Live Training to Small and Large Groups; Both In-Person and Web-Based.
- Strong Public Speaking, Writing and Legal Research Skills.
Required Licenses/certifications:
- An Active California State Bar License;
- Ongoing Compliance with California State Bar Mandates for Continued Education Hours;
- Valid Driver's License;
Preferred Licenses/certifications
- An Active Certified Specialist, Workers' Compensation Law, the State Bar of California Board of Legal Specialization;
- Ongoing Compliance and Recertification for State Bar of California Certified Specialist in Workers' Compensation;
- Self-Insurance Plans Certificate Is Desired.
Special Qualifications:
- Experience Providing Advice and Counsel to Public Sector Clients;
- Experience Drafting Employee Handbooks, Employee Policies and Procedures and Responses as It Relates to Workers' Compensation Laws and Practices;
- Experience Litigating Workers' Compensation Cases;
- Experience Trying Workers' Compensation Cases to The Wcab or In Administrative Proceedings.
Skills and Competencies:
- Analytical Skills: Ability to Analyze Complex Information, Identify Key Issues, and Make Informed Decisions.
- Communication Skills: Excellent Written and Verbal Communication Skills, with The Ability to Convey Complex Information Clearly to Various Stakeholders.
- Negotiation Skills: Strong Negotiation and Settlement Skills, with The Ability to Achieve Favorable, Fair and Equitable Outcomes.
- Legal Knowledge: In-Depth Understanding of California Workers' Compensation Laws, Regulations, and Legal Procedures.
- Interpersonal Skills: Ability to Build and Maintain Relationships with Internal and External Parties.
- Organizational Skills: Exceptional Time Management and Organizational Abilities, Capable of Handling Multiple Claims Simultaneously.
- Problem-Solving: Strong Critical Thinking and Problem-Solving Abilities, with A Focus on Innovative Solutions.
- Leadership Experience: Experience Mentoring and Training Claims Professionals.
- Strategic Thinking: Ability to Develop and Implement Long-Term Strategies to Mitigate Claims Costs and Improve Claims Outcomes.
- Industry Knowledge: Up-To-Date Knowledge of Industry Trends, Emerging Risks, and Best Practices in Large Loss Claims Management
- Technical Skills: Proficiency in Claims Management Software and Micr
