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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.
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
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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.
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 $78,000 - $85,000. 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.
Global provider of risk, benefits, and integrated business solutions.
Visit company websiteJobs and hiring trendsUSD 78000-85000 yearly / year
Full-time
Entry
Remote
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