Randy Jouben’s Game-Changing Strategy in Workers’ Compensation Is a Must-Read for Every Employer

Randy Jouben led an overhaul of Fairfax County’s risk management program, enhancing worker care and reducing workers’ compensation claims.
By: | July 14, 2023

Following a leadership change in 2018, the Fairfax County risk management program needed a complete overhaul.

Employees had previously expressed concerns that the workers’ compensation program was too focused on cost savings — to the detriment of injured workers’ experience.

In stepped the county’s new risk manager, Randy Jouben, and his team.

Based on staff feedback and his own analysis, Jouben introduced four key initiatives that would put greater focus on the injured worker and simultaneously improve overall outcomes: on-site physical therapy, expanded networks, wellness checks and integration of pharmacy.

He looked to on-site physical therapy to improve triage services and early intervention on work readiness. Initially provided for firefighters, the program was such a success that the police department asked to be included.

The on-site personal trainer also became a resource for employees to improve their fitness and alleviate minor symptoms before they became major problems.

In partnership with its managed care vendor, CorVel Corporation, Jouben revised the provider panels with a focus on those who could deliver a seamless employee experience. The vetting process included an analysis of physicians and their office staff, availability and expertise in treating workers’ compensation patients.

The panels were also expanded to include comprehensive urgent care in 36 locations and 50 specialty providers in neurosurgery, ENT, neurology and cardiology. Jouben also created a panel of mental health professionals to address injured workers’ mental health needs.

Under his leadership, wellness check services are now in place to identify potential barriers to recovery and support employees by touching base with them throughout the claims process. These check-ins have contributed to a reduction in indemnity days and referrals for mental health services due to post-injury depression.

Per his initial pledge, the pharmacy program was also integrated into the overall workers’ compensation program to provide greater claims visibility, track opioid use and identify early warning signs of potential dependency.

“Although I had a great deal of support in making the proposed changes, the greatest challenge was building trust with stakeholders,” said Jouben.

“The proposals we were making had not been tried anywhere else, so there was no way to provide empirical evidence that these changes would be for the better.”

Jouben overcame these challenges by communicating to the stakeholders one-on-one and “showing them how much we cared about making a change and how they would be in the best interest of the employees.” &


Every year, Risk & Insurance selects deserving candidates to become Risk All Stars. These are risk managers who, through their perseverance, passion and creativity, make a big difference to the stability of their organizations.

See all the 2023 Risk All Star Winners here.

Alex Wright is a UK-based business journalist, who previously was deputy business editor at The Royal Gazette in Bermuda. You can reach him at [email protected].

More from Risk & Insurance