VP, Clinical Operations

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. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

This role manages program design, product portfolio, service delivery, customer satisfaction, renewal, and profitability of specific national, regional, or assigned accounts. It ensures efficient, cost-effective, and high-quality delivery of clinical services to clients such as Home Health, Post Acute, and Physical Therapy.

Responsibilities

• Plans for staffing needs including succession, bench-strength, and new business.
• Establishes business plans with goals and objectives for the area and locations/offices.
• Establishes policies and procedures to assure compliance with best practices, clinical operations service standards, state regulations, and client service requirements.
• Advances physical therapy clinical standards, best practices, treatment guidance, documentation expectations, and quality priorities to support consistent, defensible, and high-value clinical recommendations.
• Develops and implements annual budget and manages expenses within established budgetary guidelines.
• Ensures efficient, cost-effective, quality program delivery for medical and disability management.
• Provides clinical oversight of dedicated units.
• Offers client-facing clinical support for physical therapy program reviews, escalations, strategic discussions, and consultative conversations related to outcomes, utilization, treatment quality, and program value.
• Collaborates with Claims, Clinical Strategy leaders, Operations, Product, Network, Compliance, Finance, and Analytics partners to align physical therapy services with broader business priorities and integrated service models.
• Leverages clinical, operational, and outcomes data to identify trends, guide strategy, support program refinement, and recommend enhancements that improve effectiveness, consistency, and client impact.
• Develops training materials to meet training needs.
• Manages the department's case management and utilization review directors, managers, supervisors, and units nationally.
• Promotes a culture of continuous improvement, collaboration, accountability, and evidence-based practice across the physical therapy clinical team.
• Partners with Clinical Business Operations and other operational leaders to ensure clinical standards are effectively supported within workflows, service expectations, process design, and quality improvement efforts.

Supervisory Responsibilities

• Administers company personnel policies in all areas and follows company staffing standards and training recommendations.
• Interviews, hires, and establishes colleague performance development plans; conducts colleague performance discussions.
• Provides support, guidance, leadership, and motivation to promote maximum performance.

Requirements

• Bachelor's degree in a health-related field or equivalent work experience preferred.
• Current unrestricted clinical license required.
• Certification in case management, rehabilitation nursing, or a related specialty OR board certification required.
• Ten (10) years of related experience or equivalent combination of education and experience required, including:
  • Five (5) years of medical case management.
  • Three (3) years of clinical quality control.
  • Three (3) years of supervisory experience.

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, travel as required.
• Auditory/Visual: Hearing, vision, and talking.
• When applicable and appropriate, consideration will be given to reasonable accommodations.

Benefits

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including:
  • Medical, dental, and vision coverage.
  • 401K with company match from day one.
  • Paid time off (PTO).
  • Disability and life insurance.
  • Employee assistance program.
  • Flexible spending or health savings account.
  • Additional voluntary benefits.

Pay

For the jurisdiction noted in this job posting, the range of starting pay for this role is $127,000.00 - $178,000.00 per year.