Note: The job is a remote job and is open to candidates in USA. Sedgwick Claims Management Services Inc. is seeking a Clinical Team Lead Sr to ensure efficient and high-quality delivery of case management services across multiple business lines. The role involves supervising and training colleagues, managing cases, and ensuring customer satisfaction through effective account management processes.
Responsibilities
- Plans for staffing needs including succession, bench-strength, and new business
- Establishes business plan with goals and objectives for the area and locations/offices
- Establishes policy and procedures to assure compliance to best practices, claims management services standards, state regulations, and client service requirements
- Supervises, coordinates, and reviews the work of assigned staff for a single business line while on-site at client locations
- Makes budget recommendations; manages assigned budget to ensure achievement of unit financial goals
- Acts as liaison between telephonic and onsite case management
- Participates in account support and management
- Provides expertise in client specific case management requirements and in client union involvement
- Provides expert medical and product support to staff
- Administers company personnel policies in all areas and follows company staffing standards and training recommendations
- Interviews, hires and establishes colleague performance development plans; conducts colleague performance discussions
- Provides support, guidance, leadership and motivation to promote maximum performance
Skills
- Bachelor's degree or higher in a health-related field AND licensure as a health professional (where such licensure is available)
- Certification as a case manager
- Professional certification in a clinical specialty with three (3) years experience as case manager AND certification as case manager if directly supervising case management process experience
- Eight (8) years of related experience or equivalent combination of education and experience required to include three (3) years medical case management, two (2) years clinical and two (2) years supervisory experience
- Solid knowledge of multiple business line medical case management environments
- Knowledge of resources available regarding the regulations and parameters of third party reimbursement, benefit determinations, and payments
- Knowledge of statutory requirements of state's jurisdiction/ERISA regulations
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Good leadership/management/motivational skills
- Strong 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
- 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
- Computer keyboarding
Benefits
- 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.
- 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.
- 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.
Company Overview
Company H1B Sponsorship