Disability Clinical Specialist
Company: Sedgwick
Location: Jacksonville
Posted on: June 25, 2022
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Job Description:
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International applicants, mainly Australia. If this does not apply
to you please use the 'Apply' option.**
Disability Clinical Specialist
IF YOU CARE, THERE'S A PLACE FOR YOU HERE
For 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.
**PRIMARY PURPOSE** : To perform clinical evaluations, consult
providers and employees; to provide case direction; and to ensure
medical information substantiates the need for absence from
work.
**ESSENTIAL FUNCTIONS and RESPONSIBILITIES**
+ Performs clinical review of referred claims; documents decision
rationale; and completes medical review of all claims to ensure
information substantiates disability.
+ Provides clear and appropriate follow-up recommendations for
ongoing medical management of claims; ensures appropriate
recommendations are made on claims.
+ Makes timely, appropriate contact with employee and/or providers
to discuss employee's clinical status, progress and work
status.
+ Achieves appropriate quality audit scores on a consistent
basis.
+ Acts as clinical resource to colleagues within the program.
**ADDITIONAL FUNCTIONS and RESPONSIBILITIES**
+ Performs other duties as assigned.
+ Supports the organization's quality program(s).
+ Travels as required.
**QUALIFICATIONS**
**Education & Licensing**
Bachelor's degree or equivalent preferred. RN, LVN, CRC, COHN CVD,
LPC and/or LCSW preferred. Current license, registration and/or
professional designations as required within the jurisdiction.
Clinical expertise must be kept current by acquisition of the
necessary CEUs to maintain licenses and designations.
**Experience**
Four (4) years of related experience or equivalent combination of
education and experience required to include experience in a direct
medical/psychological setting or physical industrial medicine and
previous insurance experience.
**Skills & Knowledge**
+ Knowledge of current medical practices in health care management
in a variety of areas (including, but not limited to, orthopedics,
general medicine for acute and chronic conditions, general surgery,
mental health, obstetrics, oncology, and physical and occupational
rehabilitation)
+ Oral and written communication, including presentation skills
+ PC literate, including Microsoft Office products
+ Analytical and interpretive skills
+ Strong organizational skills
+ Excellent interpersonal 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 is an Equal Opportunity Employer and a Drug-Free
Workplace.
Keywords: Sedgwick, Jacksonville , Disability Clinical Specialist, Healthcare , Jacksonville, Florida
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