Telephonic Case Manager

Sedgwick

1d•$72,000 - $75,000•Remote

About The Position

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. This role offers a remote work environment with flexibility and autonomy in daily work, location, and career path, while advocating for the most effective and efficient medical treatment for injured employees. The position enables the Caring counts® mission supporting injured employees from some of the world’s best brands and organizations, and is part of a rapidly growing, industry-leading global company known for its excellence and customer service. The role involves celebrating career achievements and each other through professional development opportunities, continuing education credits, team building initiatives, and access to diverse and comprehensive benefits to take care of mental, physical, financial, and professional needs.

Requirements

Current unrestricted RN license(s) in a state or territory of the United States required.
Computer keyboarding

Nice To Haves

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.

Responsibilities

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.