Full-Time

Telephonic Case Manager

Confirmed live in the last 24 hours

Sedgwick Claims Management Services

Sedgwick Claims Management Services

10,001+ employees

Claims management and risk solutions provider

Financial Services
Healthcare

Compensation Overview

$73k - $75kAnnually

Junior, Mid

Remote in USA

Category
Nursing & Allied Health Professionals
Medical, Clinical & Veterinary
Requirements
  • 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.
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.
Sedgwick Claims Management Services

Sedgwick Claims Management Services

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Sedgwick specializes in claims management and risk solutions for the insurance and corporate sectors. The company assists organizations in efficiently managing and resolving various types of claims, including property damage and employee injuries. Sedgwick's services include clinical case management, where they oversee the medical care of injured employees, and provide networks to improve outcomes. They charge fees for their services, which range from initial claims assessment to ongoing case management, and also offer specialized services like home inspections and property appraisals. What sets Sedgwick apart from competitors is its strong emphasis on diversity, equity, and inclusion, which is a core value that enhances its service delivery. The company's goal is to provide comprehensive solutions that help clients reduce costs and improve efficiency in the claims process while caring for people.

Company Stage

Growth Equity (Non-Venture Capital)

Total Funding

$488.1M

Headquarters

Memphis, Tennessee

Founded

N/A

Simplify Jobs

Simplify's Take

What believers are saying

  • Sedgwick's expansion into global marine and aviation claims management demonstrates its ability to adapt and grow in specialized markets.
  • The launch of AI-powered care guidance applications showcases Sedgwick's commitment to leveraging technology for improved claims outcomes.
  • The company's strong leadership and strategic appointments, such as the promotion of Ronnie Adcock and the appointment of Paul Burns, indicate a focus on experienced and capable management.

What critics are saying

  • The retirement of long-time Executive Chairman Dave North could lead to a period of strategic uncertainty and transition challenges.
  • The complex and evolving legal landscape, as highlighted in Sedgwick's liability litigation report, poses ongoing challenges for effective claims management.

What makes Sedgwick Claims Management Services unique

  • Sedgwick's comprehensive managed care and cost containment solutions, including clinical case management, set it apart from competitors who may not offer such integrated services.
  • The company's strong emphasis on diversity, equity, and inclusion (DEI) enhances its ability to serve a wide range of clients and communities effectively.
  • Sedgwick's global reach and specialized services in sectors like marine and aviation claims management provide a unique competitive edge.

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