Clinical Manager

Sedgwick; Baltimore (MD); Hybrid; USD 84,000 - 100,000; Full time

Benefits offered by this job

Flexible schedule

Referral incentive program

Agile environment

Career development

Job summary

Sedgwick is seeking a Clinical Manager in Baltimore, MD. This hybrid role requires onsite attendance at our Baltimore office on Tuesdays and Thursdays, with remote work on other days.

You will lead clinical operations for multiple teams, ensure high-quality case management and utilization review services, and partner with clients and Sedgwick University for staff development. Ideal candidate has a BSN or Master’s in Vocational Rehabilitation with eight years’ related experience, including

Qualifications

• Bachelor's degree in nursing (BSN) or master's degree in Vocational Rehabilitation.
• Certification in case management or rehab counseling preferred.
• Valid driver's license required.

Responsibilities

• Manages clinical operations for multiple units or a large dedicated unit.
• Provide expert medical and product support to claims and clinical staff.
• Promote URAC standards and ensure compliance for URAC certification.
• Plan staffing, training, and development; supervise assigned staff.
• Establish policy/procedures to assure compliance with standards and regulations.
• Monitor area performance through management reports.
• Deliver corporate training with Sedgwick University and coordinate certification of training materials.
• Support budget decisions and ensure achievement of financial goals.
• Identify new product opportunities and present to clients and colleagues.
• Develop and maintain positive client relationships.

Skills

Clinical operations management

Case management

Utilization review

Leadership / supervision

Budget management

Education

BSN

MS in Vocational Rehabilitation

Certification in case management

Certification in rehab counseling

Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do everyday 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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Clinical Manager

Please Note: This is a hybrid position requiring onsite attendance at our Baltimore - St. Paul office (7 St. Paul Street, Suite 450 Baltimore, MD 21202) on Tuesdays and Thursdays each week, with remote work available on the remaining business days.

Are you looking for an opportunity to join a global industry leader where you can bring your big ideas to help solve problems for some of the world’s best brands?

• Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world’s most respected organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Leverage Sedgwick’s broad, global network of experts to both learn from and to share your insights.
• Take advantage of a variety of professional development opportunities that help you perform your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE?

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

PRIMARY PURPOSE OF THE ROLE

To ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients by managing and training either a dedicated unit or multiple units of colleagues located in claims offices and on site at client locations; to provide expertise in client specific case management and utilization review requirements; and to ensure customer satisfaction through the provision of these services.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

• Manages overall clinical operations for less than three (3) assigned teams/offices or one (1) large dedicated unit; assists in developing and implementing clinical objectives and initiatives.
• Assists with implementation of new business plan with goals and objectives for assigned locations/offices; provides expert medical and product support to Sedgwick CMS claims and clinical staff.
• Promotes and adheres to all URAC standards and assures compliance to maintain successful URAC certification.
• Identifies challenges and creates solution for recruitment, hiring, staffing, process management and training needs; plans for staffing needs, including succession, bench‑strength and new business; and supervises, coordinates and reviews the work of assigned staff.
• Assists in establishing policy and procedures to assure compliance to best practices, clinical management services standards, state regulations, and client service requirements.
• Monitors management reports relating to the area/office performance.
• Delivers corporate training for clinical staff in conjunction with Sedgwick University; provides direct oversight of clinical orientation program; and coordinates with Sedgwick University for certification of training materials.
• Provides assistance to the Director Clinical Operations in making budget recommendations; manages budget ensuring achievement of unit financial goals; ensures effective deployment of strategic project plans.
• Identifies potential new product opportunities, processes and protocols; participates in presentations to clients, prospects and colleagues.
• Supports and interfaces with account management; provides expertise in client specific case management and utilization review requirements; and develops and maintains positive, productive relationships.

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.

QUALIFICATIONS

Education & Licensing - Bachelor's degree in nursing (BSN) or master's degree in Vocational Rehabilitation from an accredited college or university or equivalent work Experience preferred. Certification in case management or certification in rehab counseling preferred. Valid driver's license required.

Experience - Eight (8) years of related experience or equivalent combination of education and experience required to include three (3) years of medical or vocational case management, three (3) years clinical or three (3) years of vocational, and two (2) years supervisory experience. Workers compensation or disability experience preferred.

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Opportunity to work in an agile environment. [If Applicable]
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

WORK ENVIRONMENT REQUIREMENTS

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

Physical: Computer keyboarding

Auditory/Visual: Hearing, vision and talking

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 $84,000 - $100,000/year. 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.

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time.

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