Telephonic Triage Nurse Case Manager (Remote) 2025-1436

Sedgwick 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.

Are you looking to make a difference by providing high-quality care with a personal touch that impacts the lives of workers? Would you like to be part of a team focused on empowering and sustaining health by supporting the occupationally injured? Do you have the professional nursing, case management experience, and licenses necessary to help further establish Sedgwick Government Solutions as a leading case management company? We believe in helping those with work-sustained illnesses and injuries to live their best life by providing care, health management, and support through our highly skilled team of home-based Telephonic Triage Nurse Case Managers. As a Telephonic Triage Nurse Case Manager with an active RN license from Puerto Rico residing in the continental US, you will work independently in your home office setting while still being part of a supportive team nationwide. Through the application of a unique mix of experience and certification, you will support federal workers with diagnoses in the fields of occupational-related injuries and illness, emphasize timely facilitation and coordination of diagnosis, and be involved in the acute phases of treatment and support. Your broad responsibilities will include developing a case management plan for each injured worker throughout the various stages of recovery while tracking in a database the patient's improvement goal. You will implement integrated medical disability case management services to prevent, minimize, or overcome a disability, as well as provide medical expertise and serve as the critical communication link between the parties involved in any medical disability case.

Accepts assignments based on referrals from DOL with service period limitations Responsible for coordinating timely contact and information sharing with the injured worker, treating provider, and the Agency. Accurate, timely documentation of contact attempts and communications in assigned case management systems, as identified by SGS, as well as DOL Conduct and document an assessment of each injured worker/employee, including (as appropriate) regarding clinical and non-medical obstacles. psychosocial status, consumer knowledge, education needs to health status and treatment plan, past relevant history, and possible non-medical impediments to successful resolution Collaborate and communicate with the injured worker/employee, providers, employer, or the employer's representative in the execution of a plan for return to work or other productive activity. Identify and obtain any required or outstanding medical documentation in support of the individual's plan for a return to work or other productive activity. Understand and implement criteria for the discharge of injured workers from TN services Identify cases that would benefit from additional case management services, such as assignment of a DOL Field Nurse Promote goodwill by assisting all parties involved with issues related to the injured worker/employee, provider relations, and OWCP coordination, as applicable. Understand the organization's quality management program and the case manager's role within that program Is an effective team member; supports the team by pitching in at any level and effectively working across the organization to meet the needs of the business Take ownership of personal actions and outcomes. Embrace change; maintain an open mind, and be flexible and adaptable in the face of ambiguity and change Ability to work independently, multitask, and adjust priorities Proactively seek opportunities to increase knowledge, skills, and abilities May perform other duties, as needed, to meet the needs of the business Ability to utilize a case management system, Electronic Medical Record, or other electronic platform Ability to utilize telehealth technologies (video, chat, etc.), when appropriate, for a variety of clinical care and care management services. Demonstrated ability to use Microsoft applications and demonstrate basic electronic technology understanding Computer literacy, including MS Word, Excel, and Outlook