Telephonic Case Manager

About the role

While partnering with the injured worker, employer, and medical providers, create a case management strategy to facilitate medical recovery and a successful return to work through advocacy, communication and coordination of medical services.

Join Sedgwick and be part of something meaningful with 33,000 colleagues supporting people worldwide facing the unexpected. Grow your career, experience a caring culture, and enjoy work-life balance in a company recognized as a top workplace by Newsweek, Fortune, and Great Place to Work®.

Responsibilities

• Performs initial and ongoing clinical assessment via telephone calls to evaluate the injured worker's injury, medical treatment, psychosocial needs, cultural implications, and support systems.
• Effectively communicates and builds relationships with the claims examiner, client, injured worker, attorney, and supervisor.
• Identifies issues related to delayed recovery and/or return to work and problem solves with a creative thinking approach.
• Negotiates treatment and disability duration with providers through use of medical and disability duration guidelines, adhering to quality.
• Identifies opportunities to expedite care for cost containment and timely medical recovery.
• Provides recommendations for alternate clinical resources to support claim resolution.
• Maintains client's privacy and confidentiality, promotes client safety and advocacy; and adheres to ethical, legal, accreditation, and regulatory standards.

Requirements

• Current unrestricted RN license(s) in a state or territory of the United States required.
• Bachelor's degree in nursing (BSN) from accredited college or university or equivalent work experience preferred.
• Certification in case management, rehabilitation nursing, or a related specialty is highly preferred.

Work Environment

• 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.
• Physical: Computer keyboarding.
• Auditory/Visual: Hearing, vision, and talking.
• Remote work environment with flexibility and autonomy in daily work and location.

Benefits

• Medical, dental, and vision coverage.
• 401K with company matching.
• Paid time off (PTO).
• Disability and life insurance.
• Employee assistance program.
• Flexible spending or health savings account.
• Additional voluntary benefits.
• On-going learning and professional growth opportunities, including continuing education credits.
• Team building initiatives and recognition of career achievements.

Pay

For the jurisdiction noted in this job posting, the range of starting pay for this role is $72,000 - $75,000.