Claims Manager - Modesto, CA

About Us

We are California’s largest regional, full-service grocery chain, founded over 70 years ago in Modesto, California. With 194 stores across Central and Northern California and Western Nevada, our banners—Save Mart, Lucky, and Food Maxx—are cherished regional brands, serving the unique needs of their communities. It’s our 12,000 passionate who make our company a great place to work and shop. We prioritize investing in our people, stores, and neighborhoods, and work closely with local suppliers to bring fresh, quality products at affordable prices to our customers.

Shoppers can access our offerings in-store, online, or through convenient home delivery and curbside pick-up. The Save Mart Companies is part of The Jim Pattison Group, a family‑owned, diversified holding company headquartered in Vancouver, BC, focused on long‑term growth and innovation.

Claims Manager – Modesto, CA

The Claims Manager investigates, evaluates, and manages all workers’ compensation, general liability, and insurance claims for the company. This role documents claims and circumstances, investigates claims, assesses liability and compensability, establishes reserves and settlement values, and processes claims through to closure. The Claims Manager works closely with the Director of Risk Management to prepare and present claims for settlement or closure.

The incumbent collaborates with Company Leadership, Department Managers, Legal staff, and third‑party administrators (TPAs) to report, administer, and resolve claims effectively. The role requires advanced analytical skills to review operational procedures, business data, loss trends, and present findings to internal and external stakeholders. A strong knowledge of Workers’ Compensation, General Liability, and insurance regulations in California and Nevada, along with demonstrated experience in claims management and reserve setting, is essential.

• Investigates claims through evidence gathering, witness interviews, incident report review, and documentation of claim circumstances.
• Evaluates claim validity and compensability by analyzing whether injuries arose in the course of employment for workers’ compensation claims and assessing company legal liability for general liability claims.
• Establishes and adjusts claim reserves based on severity, exposure, and historical loss data as claims develop.
• Ensures timely reporting of claims to insurance carriers, third‑party administrators, and regulatory agencies within statutorily required time frames.
• Maintains compliance with state‑specific workers’ compensation laws across California and Nevada jurisdictions, meeting all filing deadlines, attending required conferences and hearings, and responding to regulatory inquiries.
• Represents the company at legal proceedings, program audits, vendor meetings, and regulatory and court hearings.
• Analyzes claim trends and root causes to identify patterns in incidents across the store portfolio, then develops and implements corrective action plans and preventive measures. Coordinates with store operations, facilities, and safety teams to address hazardous conditions, implements training programs, and modifies procedures to reduce future claim frequency and severity.
• Works with retail, logistics, back‑office support, and corporate management on risk awareness related to various policies and procedures.
• Communicates with employees and management regarding the needs and changes of the insured claims programs on a regular basis.
• Oversees relationships with insurance carriers, third‑party administrators, defense counsel, medical providers, and vendors. Selects and directs defense counsel for litigated claims, reviews legal bills for reasonableness, and monitors litigation strategy and outcomes.
• For workers’ compensation claims, coordinates medical treatment, authorizes care within established guidelines, and works with medical case managers to facilitate appropriate treatment and return‑to‑work programs.
• Develops and implements modified duty and transitional work programs to return injured employees to work as quickly as medically appropriate, coordinating with…