Logo for Sedgwick Ireland

Telephonic Case Manager

Role overview

Qualifications

  • Current unrestricted RN license(s) in a state or territory of the United States
  • Bachelor's degree in nursing (BSN) or equivalent work experience
  • Certification in case management, rehabilitation nursing or a related specialty (preferred)
  • Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion

Responsibilities

  • Perform initial and ongoing clinical assessment via telephone to evaluate the injured worker's condition
  • Effectively communicate and build relationships with the claims examiner, client, injured worker, attorney, and supervisor
  • Identify issues related to delayed recovery and/or return to work and problem-solve creatively
  • Negotiate treatment and disability duration with providers according to guidelines

Key facts

Other skills

  • Communication
  • Advocacy
  • Creativity
  • Problem Solving
  • Negotiation
  • Client Confidentiality
  • Teamwork
  • Critical Thinking
  • Time Management

About the company

Sedgwick Ireland logo

Sedgwick Ireland

Insurance

Sedgwick, previously operating under the OSG Vericlaim brand, is Ireland's largest and longest established Specialist Third Party Administrator and Loss Adjuster. We are a SEDGWICK Company and part of the Global Sedgwick Organisation backed by the resources of the Leading Global Provider of technology enabled risk and claims solutions we can truly offer a local market based service operating to market leading international standards. Having built on our history and heritage as Chartered Loss Adjusters, today we provide a diverse and extensive range of outsource services for the Insurance and Financial Sectors in Ireland and Internationally. A unique business model incorporating industry and market experience, the application of behavioural science, lean process management and modern technology sets Sedgwick apart from the competition in our chosen markets. Providing the service layer between our clients and their customers we have a proven pedigree and reputation for operational excellence delivering the widest range of specialist and technical services in the market. The Sedgwick difference is our People and a desire to develop our talent for the benefit of all our stakeholders. Taking Care of People "Caring Counts” is at the heart of everything we do and the guiding principal in the development of Sedgwick becoming the leading broad based service provider we are today. We are Regulated as an Insurance Intermediary with the Central Bank of Ireland, have full EU Passport status and meet all Fiduciary and Corporate Governance Standards.

Company details

Company typeStartup
IndustryInsurance
Company size201 - 500

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Job description

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

Certified as a Great Place to Work®

Fortune Best Workplaces in Financial Services & Insurance

Telephonic Case Manager

This position is a remote position, however; you will be required to go into the Newport News, VA office from time to time. You must live in this area in order to be considered.

PRIMARY PURPOSE OF THE ROLE: 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.

ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

  • Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.
  • Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.
  • Enjoy flexibility and autonomy in your daily work, your location, and your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting. 
  • Enable our Caring counts® mission supporting injured employees from some of the world’s best brands and organizations. 
  • Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service. 
  • Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more. 
  • Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs. 

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

  • 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.

EDUCATION AND LICENSING

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.

When applicable and appropriate, consideration will be given to reasonable accommodations. 

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.

Physical: Computer keyboarding.

Auditory/Visual: Hearing, vision and talking 

TAKING CARE OF YOU BY

  • Offering a blended work environment.
  • Supporting meaningful work that promotes critical thinking and problem solving.
  • Providing on-going learning and professional growth opportunities.
  • Promoting a strong team environment and a culture of support.
  • Recognizing your successes and celebrating your achievements.
  • Thrives when everyone is working towards the same vision/goals.
  • We offer a diverse and comprehensive benefits package including:
  • Three medical, and two dental & vision plans to choose from.
  • Tuition reimbursement
  • 401K plan that matches 50% on every $ you put in up to the first 6% you save.
  • 4 weeks PTO your first full year.  

NEXT STEPS

If your application is selected to advance to the next round, a recruiter will be in touch.

#nurse #telephoniccasemanager

As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is $73,000 - $75,000.  A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace.

If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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