Telephonic Case Manager

Primary Purpose of 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.

• 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.

Current unrestricted RN license(s) in a state or territory of the United States required. Bachelor’s degree in nursing (BSN) from an accredited college or university or equivalent work experience preferred. Certification in case management, rehabilitation nursing or a related specialty is highly preferred. When applicable and appropriate, consideration will be given to reasonable accommodations.

• 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.

• Computer keyboarding.

• Hearing, vision and talking.

Offering a blended work environment. Supporting meaningful work that promotes critical thinking and problem solving. Providing ongoing learning and professional growth opportunities. Promoting a strong team environment and a culture of support. Recognizing your successes and celebrating your achievements.

• Three medical plans and two dental & vision plans to choose from.
• Tuition reimbursement.
• 401(k) plan that matches 50% on every dollar you put in up to the first 6% you save.
• 4 weeks paid time off in your first full year.

The range of starting pay for this role is $73,000 – $75,000.

Sedgwick is an Equal Opportunity Employer and a Drug‑Free Workplace.