Telephonic Case Manager

📋 Description

• • As a Telephonic Case Manager at Sedgwick Claims Management Services, Inc., you will play a pivotal role in facilitating the medical recovery and successful return to work for injured individuals. This is a remote position, requiring you to reside in Ohio, offering a unique blend of a rewarding career focused on improving health outcomes and the flexibility of a home-based work environment.
• • Your primary responsibility will be to partner collaboratively with the injured worker, their employer, and medical providers to develop and implement a comprehensive case management strategy. This involves leveraging your medical, clinical, or rehabilitation knowledge to navigate complex medical conditions, guide treatment planning, and support recovery from illness or injury.
• • You will be the primary point of contact, conducting initial and ongoing clinical assessments via telephone. These assessments are crucial for evaluating the injured worker's condition, understanding their medical treatment plan, identifying psychosocial needs, and considering cultural implications and support systems that may impact their recovery.
• • A key aspect of this role is effective communication and relationship building. You will engage regularly with claims examiners, clients, injured workers, attorneys, and supervisors, ensuring all parties are informed and aligned on the case management strategy.
• • You will proactively identify issues that may impede recovery or delay a return to work. Employing creative thinking and problem-solving skills, you will work to overcome these challenges and facilitate progress.
• • A significant part of your role will involve negotiating treatment plans and disability durations with medical providers. This requires a thorough understanding of medical and disability duration guidelines, ensuring that all negotiations adhere to quality standards and best practices.
• • You will actively seek and identify opportunities to expedite medical care, focusing on both cost containment and the timely medical recovery of the injured worker.
• • Providing recommendations for alternative clinical resources will be essential to support the efficient and effective resolution of claims.
• • Maintaining the utmost client privacy and confidentiality is paramount. You will uphold ethical, legal, accreditation, and regulatory standards, while consistently promoting client safety and acting as a dedicated advocate for their well-being.
• • This role offers a high degree of autonomy and flexibility in your daily work, allowing you to manage your schedule and approach to case management. You will have the opportunity to advocate for the most effective and efficient medical treatment for injured employees in a non-traditional, remote setting.
• • By joining Sedgwick, you become part of a global company renowned for its excellence and customer service, contributing to our 'Caring counts®' mission. You will support injured employees from some of the world's leading brands and organizations, making a tangible impact on their lives.
• • We are committed to your professional development, offering ongoing learning opportunities, support for continuing education credits, and team-building initiatives to foster a strong sense of community and shared success.
• • You will be part of a rapidly growing, industry-leading organization that values its employees and provides a supportive work environment.
• • The role encourages critical thinking and problem-solving, providing a stimulating and intellectually engaging career path.
• • You will celebrate your career achievements and those of your colleagues, contributing to a positive and motivating workplace culture.
• • Sedgwick has been recognized for its commitment to its employees, earning accolades such as Newsweek's America's Greatest Workplaces, certification as a Great Place to Work®, and inclusion in Fortune's Best Workplaces in Financial Services & Insurance.
• • This position is ideal for individuals who thrive in a collaborative environment and are driven to deliver exceptional work, making a real difference in the lives of others.
• • You will be empowered to make decisions and manage your caseload effectively, contributing to the overall success of the claims management process.
• • The company culture emphasizes support, growth, and recognition, ensuring that your contributions are valued and celebrated.
• • You will have the opportunity to work with a diverse range of cases, enhancing your expertise and broadening your professional experience in medical case management.
• • Sedgwick is dedicated to fostering a diverse, equitable, and inclusive workplace, encouraging applications from individuals with unique combinations of skills and experiences.