Manager, Telephonic Triage Case Management Services Remote ( 2025-1396)

Company: Managed Care Advisors
Location: Dublin
Posted on: February 1, 2025

Job Description:

Position Title: Manager, Telephonic Triage Case Management Services Remote ( 2025-1396)

Location: Dublin, OH, USA

Job Category: Medical Case Management

Job Type: Full Time

Description: Overview Remote: Manager, Telephonic Triage Nurse Case Manager Services - Open to Nationwide ApplicantsSalary Range: ($90k - $100k) depending on experience and qualifications. Are you eager to provide leadership, support, and oversight to a team? Do you have a commitment to helping individuals with severe and persistent workers' compensation illnesses? Sedgwick Government Solutions is an innovative organization looking for a skilled professional to manage a team of Telephonic Nurse Case Managers. As a Manager of Telephonic Triage Case Management, you will work in your home office setting while still being part of a supportive team nationwide to oversee the TN unit within the NVRS Program, collaborate with the VP of Clinical Operations, and ensure excellence in service delivery and compliance. Lead a team of skilled Telephonic Nurse Case Managers and make a significant impact on patient care.
Duties and Responsibilities

• Oversees all aspects of operations of the TN Department, including staffing, policies and procedures, regulatory and contract compliance, evaluation of outcomes, and applicable revisions to services.
• Works with VP Clinical Operations, NVRS in establishing and revising the structure and budget of the TN Department to most efficiently meet the goals of TN services.
• Ensures processes in place to support Report requirements and collaborates with other business units to ensure IT systems and data analytics capture contract deliverables and timeliness.
• Develop and oversee procedures for case assignment to TNs, as determined by volume of work, structure of Unit, and availability of qualified staff.
• Recruit, hire, and evaluate TN staff.
• Establish and enhance policies, protocols, work instructions, job aids to achieve optimum successful outcomes from TN services.
• Provide guidance to case managers in the application of policies and procedures to daily operations.
• Motivate and manage staff to ensure performance standards are not met or exceeded.
• Serve as a member of NVRS and/or SGS committees, as designated by the VP, of Clinical Operations.
• Assist VP Clinical Operations and NVRS management team in administrative functions as requested.
• Provide timely direct feedback to staff through scheduled guidance/coaching sessions and midyear/annual evaluations. This includes active coaching and engaging employees to enhance their performance and commitment.
• Assist employee to develop skills needed to achieve optimal performance and strong performance in their role.
• Actively resolve employee conflict by utilizing improvement efforts, multi-disciplinary strategies, problem-solving skills, and conflict management.
• Make timely decisions based on the evaluation of outcomes and communicate the results effectively so that the employee understands the reason behind the decision.
• Effectively counsel and coach employees on performance and behavioral improvements.
• Understand and appropriately apply employee disciplinary procedures with appropriate documentation. Coordinate terminations with CR.
• Possess professional maturity to handle confidential and delicate team and client issues
• Is an effective leader and team member; supports the team by pitching in at any level and effectively working across the organization to manage the needs of the business
• Able to work well in a team environment and manage workload, prioritize work for team and self, and meet assigned team deadlines
• Use verbal, written, and active listening skills. Communicate effectively and clearly in a professional, productive, non-aggressive manner with the team, co-workers, and clients.
• Effectively and clearly communicate articulate expectations through timely documentation submission and weekly team meeting discussions
• Provide training and other educational services for case managers, other team members, and clients, as directed by SGS Training Department.
• Foster equality and diversity in problem identification and conflict resolution among both staff and clients.
• Assume responsibility for related duties as required or assigned. Qualifications
  
  • Bachelor of Science in Nursing required.
  • Master's in nursing, health care, or business administration (or related field) preferred
  • National certification in case management or related field is required in one of the following areas: Occupational Health (COHN); Case Management (CCM), Insurance Rehabilitation (CIRS/CRRN), Disability Management (CDMS), and/or Nurse Case Manager Board Certified (ANCC/ANA).
  • Possess an active, unrestricted nursing license valid in the United States, Puerto Rico, or other U.S. territories; a Compact License is preferred.
  • 10 years of related clinical experience, including:
  • Minimum of 2 years in adult medical/surgical nursing
  • Minimum of 2 years in case management within the workers' compensation arena
  • Minimum of 1 year in adult medical/surgical nursing
  • Minimum of 3 years in case management within the workers' compensation arena
  • Minimum 3 years of telephonic case management or triage experience
  • Minimum 3 years of management experience
  • Minimum 2 years of work experience in Customer Support
  • Experience with Federal Employee Compensation Act (FECA) and FECA-related issues preferred.
  • Must write succinctly and clearly and explain complex situations in plain English to technical and non-technical audiences.
  • Strong team player; ability to partner with internal clients and other cross-functional departments
  • Ability to comprehend, analyze, and interpret documents. Ability to solve problems involving several options in situations.
  • Responsible for setting project deadlines.
  • The ability to obtain and maintain a security clearance
  • Proficiency in Microsoft Office
  • Ability to travel 20%
    For a career path that is both challenging and rewarding, join Sedgwick Government Solution's talented team. Taking care of people is at the heart of everything we do. Our clients depend on our talented colleagues to take care of their most valuable assets-their employees, and their customers. At Sedgwick Government Solutions, caring counts -. Join our team of creative and caring people of all backgrounds and help us make a difference in the lives of others.
    Sedgwick Government Solutions 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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($90,000 - $100,000). 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.
    To be considered for this position, please submit a resume, and complete the application.
    The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities, and qualifications required.
    Important InformationSuccessful candidates will be required to undergo a financial and criminal background check and obtain and maintain confidential-level security clearance upon hire. We participate in the United States Federal Government E-Verify program to confirm the employment authorization of the employee upon hire.
    Search Firm Representatives Please be advised that Sedgwick Government Solutions (Government Solutions) is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, a valid written agreement and task order must be in place before any resumes are submitted to Government Solutions. All resumes submitted by search firms to any employee at Government Solutions without a valid written agreement and task order in place will be deemed the sole property of Government Solutions and no fee will be paid in the event that person is hired by Government Solutions.
    Government Solutions strives to make our career site accessible to all users. If you need a disability-related accommodation for completing the application process, please contact Government Solutions regarding accommodations.
    Sedgwick Government Solutions is an Equal Opportunity and Affirmative Action Employer
    All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status, or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person's relatives, friends or associates.
    Sedgwick Government Solutions abides by the requirements of 41 CFR 60-741.5(a). This regulation prohibits discrimination against qualified individuals on the basis of disability and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities.
    Sedgwick Government Solutions abides by the requirements of 41 CFR 60-300.5(a). This regulation prohibits discrimination against qualified protected veterans and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans.
    About SedgwickSedgwick Government Solutions is a fully owned subsidiary of Sedgwick. Sedgwick is a leading global 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. The company provides a broad range of resources tailored to clients' specific needs in casualty, property, marine, benefits, and other lines. At Sedgwick, caring counts; through the dedication and expertise of more than 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. www.sedgwick.com Privacy - Sedgwick Terms and Conditions - Sedgwick
    
    
    
    
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Keywords: Managed Care Advisors, Middletown , Manager, Telephonic Triage Case Management Services Remote ( 2025-1396), Executive , Dublin, Ohio