Theresa Clarke
New Berlin,WI
Summary
Experienced and innovative healthcare insurance leader, self-insured and high-deductible retro programs, OSHA subject matter expert, Licensed Property and Casualty Insurance Intermediary, workers’ compensation claims management and program leadership, Third-Party Administrator (TPA) oversight, multi-jurisdictional claims management experience, RMIS platform buildout project manager, pandemic response lead supporting 75,000 healthcare employees, federal and state compliance manager, risk mitigation and cost containment strategy expert.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Manager Workers’ Compensation, Midwest Region
Advocate Health
11.2020 - Current
- Ownership of Midwest Region workers’ compensation self-insured program direction and initiatives supporting 75,000 healthcare teammates throughout Wisconsin and Illinois
- Responsible for departmental budgeting (range of $40-60m); Third-Party Administrator management; year-end actuarial audits; OSHA process owner including completing all locations 300, 301, and 300A reporting, fielding audits and investigations, and Serious Event Reporting lead.
- Leads a team of 9 workers’ compensation professionals. Departmental partnerships with Teammate Health and Safety, Safe Patient Handling, HR Senior Leadership, Site Leadership, Legal, Leave of Absence and Risk. OSHA Governance Counsel co-lead. Serious Safety Event committee member. Musculoskeletal committee member. Patient Handling Injury pillar committee member. Care For the Caregiver committee member. Bloodborne Pathogen/Needlestick exposure committee member. Ergo/safe patient handling committee member. Workplace violence prevention committee member. Mobile Duress Alarm implementation member. Appointed to Illinois Self Insureds’ Association Board of Directors 2023.
Director of Workers' Compensation (Senior Workers’ Compensation Manager)
McCabe & Kirshner, P.C.
07.2016 - 04.2020
- Development and management of a large deductible workers’ compensation captive program, acting as claims administrator for Symphony Post-Acute Network group comprised of 22 nursing home and assisted living facilities throughout Illinois and Indiana
- Oversaw daily claims management, reserve approval, settlement authority and negotiations, injured worker care and return-to-work coordination, in-house and outside counsel litigation program and vendor management.
- Program interventions resulted in consistent, three-year drop in experience mod factor with .68 experience mod in 2019. Developed front-line emergency pandemic response with EVP of Human Resources to assist healthcare employees in obtaining appropriate benefits and mitigating ultimate claim exposure overall.
Workers’ Compensation Litigation/Claims Resolution Specialist
Diamond Insurance
04.2015 - 10.2015
- Responsible for complex, litigated, high-exposure claims book of business obtaining resolution through aggressive defense and innovative litigation strategies.
- Multi-jurisdictional claims oversight including Illinois, Wisconsin, Nebraska, Indiana, and Kansas.
Corporate Risk Manager - Worker's Compensation Coordinator
Kohl's Department Stores
10.2012 - 01.2014
- Oversight of 18 jurisdictional states as employer advocate and lead Third Party Administrator claims handling.
- Partnered with risk management, safety, finance and legal departments to report on accident/injury frequency, trending, exposure projections and program improvements to develop and implement cost containment strategies.
- Performed case file audits ensuring claims are administered in accordance with Client Service Instructions, reserves were appropriate for our known exposures and action plans were set to bring claims to early and cost-effective resolution.
Sales Consultant and Claims Advocate
Aegis
09.2010 - 01.2011
- Licensed Property and Casualty Insurance Intermediary marketing and selling insurance services including Third-Party Administrative workers compensation services to governmental entities in Wisconsin and other territories.
Account Manager
Timber Creek, an FCA Packaging Brand
01.2010 - 08.2010
Claims Case Manager
Travelers Indemnity Co
11.2007 - 08.2009
Claims Representative
United Heartland
09.2003 - 11.2007
Education
MBA - Human Resources Administration
Concordia University- Wisconsin
Mequon, WI05.2024
MBA - International Business Conference
Upper Austria University of Steyr
Steyr, Austria05.2023
Bachelor of Arts - Organizational Communications
University of Wisconsin-Whitewater
Whitewater, WI05.2003
Skills
- Self-Insurance Program Management
- Healthcare Insurance
- Project Manager
- People and Process Leader
- Risk Mitigation Expert
- OSHA 10 Certified
- Licensed P&C, Health, Life, & Accident Insurance Intermediary
- Workers' Compensation
- Human Resources
- Risk Management
Certification
- OSHA 10 Certification, U.S. Department of Labor OSHA, 10/2022, No expiration date
- Wisconsin Licensed Property Casualty Insurance Intermediary
- Wisconsin Health, Life, & Accident Insurance Intermediary
- Indiana licensed claims examiner - State of Indiana
Timeline
Manager Workers’ Compensation, Midwest Region
Advocate Health
11.2020 - Current
Director of Workers' Compensation (Senior Workers’ Compensation Manager)
McCabe & Kirshner, P.C.
07.2016 - 04.2020
Workers’ Compensation Litigation/Claims Resolution Specialist
Diamond Insurance
04.2015 - 10.2015
Corporate Risk Manager - Worker's Compensation Coordinator
Kohl's Department Stores
10.2012 - 01.2014
Sales Consultant and Claims Advocate
Aegis
09.2010 - 01.2011
Account Manager
Timber Creek, an FCA Packaging Brand
01.2010 - 08.2010
Claims Case Manager
Travelers Indemnity Co
11.2007 - 08.2009
Claims Representative
United Heartland
09.2003 - 11.2007
MBA - Human Resources Administration
Concordia University- Wisconsin
MBA - International Business Conference
Upper Austria University of Steyr
Bachelor of Arts - Organizational Communications
University of Wisconsin-Whitewater