Director Client Services, Managed Care

About the Role

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. The Managed Care Client Services Director (MC CSD) is the primary managed care relationship leader for assigned clients. The role focuses on client stewardship, program performance, operational issue resolution, and strategic consultation across managed care services, including provider networks, case management, utilization review, behavioral health, bill review, specialty programs, ancillary services, and related clinical or vendor-supported solutions.

The Managed Care Client Services Director acts as a trusted advisor and connector between clients, claims operations, clinical leaders, account teams, analytics, network services, and vendor partners to ensure managed care programs are aligned with client objectives and delivering measurable value.

Responsibilities

• Serve as the primary managed care advisor and point of contact for assigned clients.
• Lead stewardship meetings, business reviews, strategic discussions, and follow-up action planning.
• Develop and deliver executive-level reporting, program insights, recommendations, and value narratives.
• Identify opportunities to improve outcomes, reduce costs, strengthen program utilization, and support client retention or growth.
• Maintain awareness of client-specific requirements, goals, operational challenges, and contractual commitments.
• Monitor managed care performance, utilization trends, service outcomes, and program effectiveness.
• Translate operational data and reporting into clear, actionable recommendations for clients and internal stakeholders.
• Support implementation of new programs, pilots, service enhancements, and process improvement initiatives.
• Partner with sales, account management, claims operations, and clinical leaders to align managed care solutions with client needs.
• Coordinate timely resolution of managed care service issues, escalations, and client concerns.
• Partner with operational leaders to identify root causes, assign ownership, and drive sustainable corrective actions.
• Ensure accountability for commitments, deliverables, action items, and communication follow-through.
• Escalate risks and barriers appropriately while maintaining clear, professional communication with impacted stakeholders.
• Support education, resource navigation, and managed care consultation for claims examiners and client-facing teams.

Requirements

• Ten (10) years related experience or equivalent combination of education and experience required to include two (2) years account manager experience or five (5) years adjuster, team lead or managed care experience.
• Analytics experience a plus.
• Residence in Central or Eastern time zones a plus.

Qualifications

• Bachelor's degree from an accredited college or university preferred.
• CPCU, AIC and/or ARM or other related designation preferred.

Benefits

We offer diverse and comprehensive benefits including medical, dental, vision, 401K and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits beginning your first day.

Pay

The range of starting pay for this role is $110,000 - $135,000/year.

Work Environment

• Physical: Computer keyboarding, travel as required.
• Auditory/Visual: Hearing, vision, and talking.
• Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.