Director of Client Services, Managed Care

Sedgwick

1d•$97,000 - $125,000•Onsite

About The Position

The Managed Care Client Services Director (MC CSD) is the primary managed care relationship leader for assigned clients. The role focuses on client stewardship, program performance, operational issue resolution, and strategic consultation across managed care services, including provider networks, case management, utilization review, behavioral health, bill review, specialty programs, ancillary services, and related clinical or vendor-supported solutions. The MC CSD acts as a trusted advisor and connector between clients, claims operations, clinical leaders, account teams, analytics, network services, and vendor partners to ensure managed care programs are aligned with client objectives and delivering measurable value.

Requirements

Bachelor's degree from an accredited college or university preferred.
CPCU, AIC and/or ARM or other related designation preferred.
Ten (10) years related experience or equivalent combination of education and experience required to include two (2) years account manager experience or five (5) years adjuster experience including two (2) years in a supervisory capacity.
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills
Excellent interpersonal skills
Excellent negotiation and facilitation skills
Leadership/management/motivational skills
Ability to work in a team environment
Excellent account rounding ability
Strong understanding of workers compensation, liability and disability claims management
In-depth knowledge of client servicing
Ability to handle conflict and confront challenging issues in a fast work environment
Ability to meet or exceed Performance Competencies

Responsibilities

Serve as the primary managed care advisor and point of contact for assigned clients.
Lead stewardship meetings, business reviews, strategic discussions, and follow-up action planning.
Develop and deliver executive-level reporting, program insights, recommendations, and value narratives.
Identify opportunities to improve outcomes, reduce costs, strengthen program utilization, and support client retention or growth.
Maintain awareness of client-specific requirements, goals, operational challenges, and contractual commitments.
Monitor managed care performance, utilization trends, service outcomes, and program effectiveness.
Translate operational data and reporting into clear, actionable recommendations for clients and internal stakeholders.
Support implementation of new programs, pilots, service enhancements, and process improvement initiatives.
Partner with sales, account management, claims operations, and clinical leaders to align managed care solutions with client needs.
Coordinate timely resolution of managed care service issues, escalations, and client concerns.
Partner with operational leaders to identify root causes, assign ownership, and drive sustainable corrective actions.
Ensure accountability for commitments, deliverables, action items, and communication follow-through.
Escalate risks and barriers appropriately while maintaining clear, professional communication with impacted stakeholders.
Support education, resource navigation, and managed care consultation for claims examiners and client-facing teams.
Performs other duties as assigned, Supports the organization's quality program(s) and Travel as required.