Telephonic Case Manager (Remote)

About the role

Sedgwick is hiring a Telephonic Case Manager to work remotely, partnering with injured workers, employers and medical providers to build a case management strategy that supports medical recovery and a successful return to work. The role relies on advocacy, communication and coordination of medical services.

Key responsibilities

• Perform initial and ongoing clinical assessments by telephone, evaluating the injured worker's injury, medical treatment, psychosocial needs, cultural implications and support systems.
• Communicate and build relationships with the claims examiner, client, injured worker, attorney and supervisor.
• Identify issues related to delayed recovery or return to work and solve them creatively.
• Negotiate treatment and disability duration with providers using medical and disability duration guidelines while adhering to quality standards.
• Identify opportunities to expedite care for cost containment and timely recovery, and recommend alternative clinical resources to support claim resolution.
• Maintain client privacy and confidentiality, promote client safety and advocacy, and follow ethical, legal, accreditation and regulatory standards.

Required profile

• Current unrestricted RN license in a U.S. state or territory.
• Bachelor's degree in nursing (BSN) from an accredited institution or equivalent work experience preferred.
• Certification in case management, rehabilitation nursing or a related specialty is highly preferred.
• Ability to think clearly, judge well, troubleshoot and solve problems, handle stress and multiple priorities, and meet deadlines.

Required skills

• Medical, clinical or rehabilitation knowledge applied to complex conditions, treatment planning and recovery.
• Computer keyboarding.

What we offer

• Blended work environment with remote work options.
• Benefits including three medical, two dental and two vision plans, tuition reimbursement, 401K with 50% match up to 6%, 4 weeks of PTO in the first year, and disability and life insurance.
• Professional development, continuing education credits and team-building activities.