Case Management Specialist
Company: Sedgwick
Location: Boca Raton
Posted on: May 13, 2022
Job Description:
The 'Apply with SEEK' option will be utilized for International
applicants, mainly Australia. If this does not apply to you please
use the 'Apply' option. Case Management Specialist IF YOU CARE,
THERE'S A PLACE FOR YOU HEREFor a career path that is both
challenging and rewarding, join Sedgwick's talented team of 27,000
colleagues around the globe. Sedgwick is a leading provider of
technology-enabled risk, benefits and integrated business
solutions. Taking care of people is at the heart of everything we
do. Millions of people and organizations count on Sedgwick each
year to take care of their needs when they face a major life event
or something unexpected happens. Whether they have a workplace
injury, suffer property or financial loss or damage from a natural
or manmade disaster, are involved in an auto or other type of
accident, or need time away from work for the birth of a child or
another medical situation, we are here to provide compassionate
care and expert guidance. Our clients depend on our talented
colleagues to take care of their most valuable assets-their
employees, their customers and their property. At Sedgwick, caring
counts -. Join our team of creative and caring people of all
backgrounds, and help us make a difference in the lives of others.
This position is a remote Telephonic Case Management Specialist
position, however; -this person must live in the area of -Palm
Beach, - West Palm Beach, Boca Raton, Jupiter, Deerfield, Coconut
Creek, or North Lauderdale areas as this person would, on occasion
have to make a field visit. - PRIMARY PURPOSE: To perform initial
and ongoing clinical assessment and evaluate need for alternative
treatment, to negotiate and coordinate appropriate medical
treatment and length of disability with providers and employers;
and to implement a case management plan with ongoing monitoring to
ensure quality and appropriate service delivery of the case
management process.ESSENTIAL FUNCTIONS and RESPONSIBILITIES -
- Performs initial and ongoing clinical assessment via telephone
calls to client (injured employee), employer, physician and
attorney as indicated; assesses client's situation for psychosocial
needs, cultural implications and support systems in place.
- Creates a case management plan based on the assessment with
measurable goals and objectives utilizing evidence-based criteria;
monitors ongoing progress toward these goals and objectives;
implements plan through case management interventions and
communication with all parties to reach desired goals and
objectives.
- Evaluates need for alternative treatment.
- Negotiates appropriate level and intensity of care and
disability duration with providers through use of medical and
disability duration guidelines, adhering to quality assurance
standards.
- Negotiates and coordinates a prompt return to work with
employer.
- Measures interventions to determine the outcome of the case
manager's involvement to include clinical, financial, variance,
quality of life, and client satisfaction; maintains accurate record
of management including costs, savings and demographic data.
- Provides case direction and supervision to field case
specialists when on-site intervention is required; ensures quality
and appropriate service delivery.
- Communicates effectively with handling claims examiner, client,
claimant, attorney and supervisor.
- Maintains client's privacy and confidentiality, promotes client
safety and advocacy; and adheres to ethical, legal, accreditation
and regulatory standards.ADDITIONAL FUNCTIONS and RESPONSIBILITIES
-
- Performs other duties as assigned.
- Supports the organization's quality
program(s).QUALIFICATIONSEducation & LicensingCurrent 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.ExperienceFive (5) years of
related experience or equivalent combination of education and
experience required to include two (2) years of fulltime equivalent
providing direct clinical care to the consumer.Skills & Knowledge
- Knowledge of workers' compensation laws and regulations
- Excellent oral and written communication, including
presentation skills
- PC literate, including Microsoft Office products
- Leadership/management/motivational skills
- Analytical and interpretive skills
- Strong organizational skills
- Excellent interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Performance Competencies WORK
ENVIRONMENTWhen 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 deadlinesPhysical: Computer keyboarding, travel as
requiredAuditory/Visual: -Hearing, vision and talkingThe statements
contained in this document are intended to describe the general
nature and level of work being performed by a colleague assigned to
this description. They are not intended to constitute a
comprehensive list of functions, duties, or local variances.
Management retains the discretion to add or to change the duties of
the position at any time. Sedgwick -is an Equal Opportunity
Employer and a Drug-Free Workplace.
Keywords: Sedgwick, Boca Raton , Case Management Specialist, Executive , Boca Raton, Florida
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