Clinical Manager

Sedgwick Claims Management Services Ltd; Baltimore, Saint Paul (MD, MN); Hybrid; USD 84,000 - 100,000; Full time

Benefits offered by this job

Flexible work schedule

Referral incentive program

Career development opportunities

Job summary

Sedgwick is hiring a Clinical Manager to oversee clinical operations and training across multiple teams in a hybrid role based in Baltimore, MD. The position requires onsite presence at the Baltimore - St.

Paul office on Tuesdays and Thursdays with remote work on other days. The role emphasizes leadership, URAC compliance, and budget oversight, with responsibilities including staff development and client-focused case management.

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.

Responsibilities

• Oversee clinical operations for up to three teams or one large unit.
• Provide expert medical and product support to claims and clinical staff.
• Ensure URAC standards and certification compliance.
• Plan staffing needs and supervise assigned staff.
• Develop and implement policies to meet regulatory and client requirements.
• Deliver corporate training and oversee clinical orientation.

Skills

Leadership

Communication

Problem solving

Education

BSN or MS in Rehab Counseling

Job description

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. 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 INCLUDE:

• 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.

If you’re excited about this role but your experience doesn’t align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world’s leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company’s expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.

For more, see sedgwick.com