Telephonic Case Manager

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.

We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.

• 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 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.

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.

Auditory/Visual:
Hearing, vision and speaking.

We offer a diverse and comprehensive benefits package including:

• Three medical, and two dental & vision plans to choose from.
• 401K 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.

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $73,000 - $75,000.

A comprehensive benefits package is offered including but not limited to medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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