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Clinical Supervisor I - Utilization Review
at Sedgwick CMS in Utah
Clinical Supervisor I
CLAIM YOUR FUTURE AS A GREAT PERFORMER!
Continuing double-digit revenue growth rates and progressive employment practices make Sedgwick Claims Management Services the place where great people can do great things for clients while maximizing their career possibilities. We have earned a reputation for innovation, quality, sustained growth, financial stability and a colleague-friendly work environment. We are proud to have been voted the Best TPA in America for 2005 and 2006, and the first and only Third Party Administrator to receive the coveted Employer of Choice designation. Come be a part of our team and "Claim Your Future."
PRIMARY PURPOSE:
To ensure efficient, cost effective, and high quality delivery of case management services to clients for a single business line by supervising and training a staff of assigned staff; and to ensure customer satisfaction through the provision of these services and through dealing directly with workers compensation claims managers, supervisors and examiners utilizing the account management process.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Supervises, coordinates, and reviews the work of assigned staff for a single business line.
Acts as liaison between telephonic and onsite case management.
Works with Program Manager to provide account support including, but not limited to data collection and analysis, attending client meetings, and recommending improvements to specified program(s).
Assures achievement of unit financial goals and customer service/satisfaction goals.
Provides expert medical and product support to staff.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the total performance management.
Travels as required.
SUPERVISORY RESPONSIBILITIES
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.
QUALIFICATIONS
Education & Licensing
One of the following is required:BS/BA degree or higher in a health-related field AND licensure as a health professional (where such licensure is available) or
Certification as a case manager or
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
Three (3) years medical case management and two (2) years clinical experience required. Supervisory experience preferred.
Skills & Knowledge
Solid knowledge of medical case management
Knowledge of resources available regarding the regulations and parameters of third party reimbursement
Knowledge of statutory requirements of different state jurisdictions
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
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
WORK ENVIRONMENT:
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, travel as required
Auditory/Visual: Hearing, vision and talking
NOTE: Credit security clearance, confirmed via a background credit check, is required for this position.
The 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 CMS is an Equal Opportunity Employer and a Drug-Free Workplace
How to apply: DO NOT use the Apply Online button. Please copy and paste the following link into your browser address bar:
http://sedgwickcms.contacthr.com/16038617
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