Telephonic Case Manager

Sedgwick; United States; Remote; USD 70,000 - 72,000; Full time

Benefits offered by this job

Medical/Dental/Vision

401K with match

PTO

Remote work

Job summary

Sedgwick in the United States is seeking a Telephonic Case Manager to collaborate with injured workers, employers and medical providers. You will develop a case management strategy to facilitate medical recovery and support a successful return to work through advocacy, communication and coordination of services.

Ideal candidates hold an active RN license, a BSN, and certification in case management preferred.

Qualifications

• RN license active in any US state or territory.
• BSN from an accredited college or university.
• Certification in case management or rehabilitation nursing preferred.

Responsibilities

• Perform initial and ongoing clinical assessment via telephone to evaluate injury, treatment needs, and psychosocial factors.
• Communicate effectively with claims examiner, client, injured worker, attorney and supervisor.
• Identify issues delaying recovery or return to work and propose solutions.
• Negotiate treatment and disability duration with providers using guidelines and standards.
• Identify opportunities to expedite care for cost containment and timely recovery.
• Maintain privacy and confidentiality and adhere to ethical, legal, and regulatory standards.

Education

RN license

BSN

Case management certification (preferred)

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

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.

ARE YOU AN IDEAL CANDIDATE? 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.
• Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.
• Enable our Caring counts® mission supporting injured employees from some of the world’s best brands and organizations.
• Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
• Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.
• Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE:

• 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.

EDUCATION AND LICENSING:

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.

TAKING CARE OF YOU BY:

• Offering flexibility and autonomy.
• Supporting meaningful work that promotes critical thinking and problem solving.
• Providing on-going learning and professional growth opportunities.
• Promoting a strong team environment and a culture of support.
• Recognizing your successes and celebrating your achievements.
• Thrives when everyone is working towards the same vision/goals.
• We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.

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

NEXT STEPS

If your application is selected to advance to the next round, recruiter will be in touch.

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 $70,000 - $72,000. 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.

#nurse #telephoniccasemanager

Sedgwickis 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.