703 Director Of IT jobs in Kansas

• Experience: 5+ years of hands-on clinical expertise
• Surgical Skills: Proficient in small animal surgery
• Leadership: Strong mentoring capabilities to inspire our team
• Lifelong Learner: Committed to continual professional development
• Community Builder: A genuine passion for fostering relationships within the community

• Take the helm at our modern facility equipped with digital radiography and an in-house lab, supported by a dedicated team
• Oversee policies and procedures to enhance our service offerings
• Cultivate lasting connections with our community-oriented clients
• Enjoy a fulfilling full-time role (Monday-Saturday, with rotating Saturdays)

• Competitive salary with performance bonuses and relocation assistance
• Medical Director stipend
• Generous PTO that rolls over for your future adventures
• Comprehensive medical, dental, and vision benefits, including HSA options
• 401(k) retirement savings plans
• AVMA PLIT coverage for peace of mind
• Paid parental leave to support your growing family
• $2,500 annual CE allowance with paid days off to attend
• Discounts for your beloved pets
• Coverage for license renewal fees & professional memberships
• Investment in your passions-whether gym memberships, charity contributions, or a National Park pass
• And so much more!

Are you ready to step into a leadership role that truly makes a difference? Family Pet Hospital, a cherished companion animal practice in Topeka, Kansas, is on the lookout for an experienced Medical Director . With our current director gearing up for retirement, this is your chance to lead a well-established practice that's been serving our community since 1995.

• Experience: 5+ years of hands-on clinical expertise
• Surgical Skills: Proficient in small animal surgery
• Leadership: Strong mentoring capabilities to inspire our team
• Lifelong Learner: Committed to continual professional development
• Community Builder: A genuine passion for fostering relationships within the community

• Take the helm at our modern facility equipped with digital radiography and an in-house lab, supported by a dedicated team
• Oversee policies and procedures to enhance our service offerings
• Cultivate lasting connections with our community-oriented clients
• Enjoy a fulfilling full-time role (Monday-Saturday, with rotating Saturdays)

• Competitive salary with performance bonuses and relocation assistance
• Medical Director stipend
• Generous PTO that rolls over for your future adventures
• Comprehensive medical, dental, and vision benefits, including HSA options
• 401(k) retirement savings plans
• AVMA PLIT coverage for peace of mind
• Paid parental leave to support your growing family
• $2,500 annual CE allowance with paid days off to attend
• Discounts for your beloved pets
• Coverage for license renewal fees & professional memberships
• Investment in your passions—whether gym memberships, charity contributions, or a National Park pass
• And so much more!

At Family Pet Hospital, we deliver exceptional care for dogs, cats, birds, rabbits, and pocket pets. We take pride in fostering a supportive, team-oriented environment where both staff and clients feel like family. Our dedicated team provides a wide range of services, ensuring every patient receives top-quality, compassionate care.

Topeka, the proud capital of Kansas, offers a welcoming, family-friendly atmosphere just an hour's drive from exciting Kansas City, Manhattan, and Lawrence. Enjoy exploring local parks, cultural offerings, and historical treasures—there's something for everyone!

If you're eager to join a compassionate team and make a tangible difference in the life of our community, we encourage you to APPLY TODAY!

• Work-Life Balance : Competitive compensation with balanced hours.
• Weekend & On-Call Freedom : No on-call, no weekends.
• Always Supported : NP/PA support at all locations, always.
• Pre-Screened Patient Interactions : Virtual care team and APP triage before physician contact.
• Flexible Scheduling : Your schedule, tailored to fit your life. No set daily shift times.
• No Overnight Duties : Sleep peacefully with no overnight call/requirements.
• Effortless documentation : Conversational and Dragon dictation.
• Meaningful Connections : Establish lasting relationships with patients and staff.
• Culture of Appreciation : Your work is valued and rewarded.
• $,500 CME and Conference Allowance : Invest in your growth.
• Full Gear : iPad with LTE, Apple Pen, AirPods provided.
• Licensure Reimbursed : We cover your medical licensure costs.
• Malpractice & Tail Covered : Full insurance peace of mind.
• Benefits : 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.
• Relocation Help: Assistance for a smooth move.
• Referral Bonus : Earn more by expanding our team.
• Travel Reimbursed : Gas and mileage for work travel.
• Career Advancement : Leadership opportunities promoted.
• UpToDate Subscription : Latest medical info at your fingertips.

• The physician serves as medical director for skilled nursing facilities (SNF) and participates in administrative and quality initiatives for the facilities he or she is responsible for;
• Medical directorship functions include attending and participating in monthly quality assurance and process improvement meetings; participating in quality improvement initiatives; providing guidance to facility staff; reviewing and revising (if necessary) facility's clinical guidelines; insuring compliance with state and federal regulations, training facility staff; and supervising facility clinical staff.
• In addition to the medical director role, the physician also serves as the attending physician for the residents residing at each facility;
• The physician collaborates with Nurse Practitioners and Physician Assistants to manage day to day resident care at each facility. Typically, each facility will have a full-time PA or NP assigned to the facility depending on the acuity and volume of the patient population;
• Physician will provide high quality, patient-centered, comprehensive primary care services by rounding on patients residing in SNFs;
• Physician is responsible for diagnosing and treating patients with acute illness, such as bacterial and viral infections, as well as chronic diseases and conditions, such as hypertension, heart disease, or diabetes
• Provider documentation is completed in Theoria's proprietary electronic health record (EHR) system, ChartEasy™
• PointClickCare, MatrixCare, and American HealthTech are the most commonly used facility EHR systems
• Participating in Theoria's Chronic Care Management, Transitional Care, RPM and other medical quality initiatives and programs
• Physician must be able to supervise collaborating nurse practitioners and physicians assistants
• Physician must be able to utilize electronic/online medical tools such as EHR systems and state/county medical systems utilized for Death Certificates and administrative functions.

• Shifts are flexible depending on physicians' schedule;
• Typically, medical directors work a minimum of 2-3 days/week at each facility they oversee;
• Rounding times are flexible with no set start and end time. Preferably, physicians start in the morning between 7-10 a.m. and finish their day when their caseload has been seen;
• No nights, weekends, or on-call
• Call is covered by Theoria's virtual care team
• This is an in-person position

• Competitive compensation package, including Medical Director stipend
• Compensation ranges approximately from $5 ,000- 400,000/year depending upon employment status and availability (PRN, Part-Time, Full-Time)
• Employer Paid - Life Insurance Policy

• Work-Life Balance : Competitive compensation with balanced hours.
• Weekend & On-Call Freedom : No on-call, no weekends.
• Always Supported : NP/PA support at all locations, always.
• Pre-Screened Patient Interactions : Virtual care team and APP triage before physician contact.
• Flexible Scheduling : Your schedule, tailored to fit your life. No set daily shift times.
• No Overnight Duties : Sleep peacefully with no overnight call/requirements.
• Effortless documentation : Conversational and Dragon dictation.
• Meaningful Connections : Establish lasting relationships with patients and staff.
• Culture of Appreciation : Your work is valued and rewarded.
• $,500 CME and Conference Allowance : Invest in your growth.
• Full Gear : iPad with LTE, Apple Pen, AirPods provided.
• Licensure Reimbursed : We cover your medical licensure costs.
• Malpractice & Tail Covered : Full insurance peace of mind.
• Benefits : 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.
• Relocation Help: Assistance for a smooth move.
• Referral Bonus : Earn more by expanding our team.
• Travel Reimbursed : Gas and mileage for work travel.
• Career Advancement : Leadership opportunities promoted.
• UpToDate Subscription : Latest medical info at your fingertips.

• The physician serves as medical director for skilled nursing facilities (SNF) and participates in administrative and quality initiatives for the facilities he or she is responsible for;
• Medical directorship functions include attending and participating in monthly quality assurance and process improvement meetings; participating in quality improvement initiatives; providing guidance to facility staff; reviewing and revising (if necessary) facility's clinical guidelines; insuring compliance with state and federal regulations, training facility staff; and supervising facility clinical staff.
• In addition to the medical director role, the physician also serves as the attending physician for the residents residing at each facility;
• The physician collaborates with Nurse Practitioners and Physician Assistants to manage day to day resident care at each facility. Typically, each facility will have a full-time PA or NP assigned to the facility depending on the acuity and volume of the patient population;
• Physician will provide high quality, patient-centered, comprehensive primary care services by rounding on patients residing in SNFs;
• Physician is responsible for diagnosing and treating patients with acute illness, such as bacterial and viral infections, as well as chronic diseases and conditions, such as hypertension, heart disease, or diabetes
• Provider documentation is completed in Theoria's proprietary electronic health record (EHR) system, ChartEasy™
• PointClickCare, MatrixCare, and American HealthTech are the most commonly used facility EHR systems
• Participating in Theoria's Chronic Care Management, Transitional Care, RPM and other medical quality initiatives and programs
• Physician must be able to supervise collaborating nurse practitioners and physicians assistants
• Physician must be able to utilize electronic/online medical tools such as EHR systems and state/county medical systems utilized for Death Certificates and administrative functions.

• Shifts are flexible depending on physicians' schedule;
• Typically, medical directors work a minimum of 2-3 days/week at each facility they oversee;
• Rounding times are flexible with no set start and end time. Preferably, physicians start in the morning between 7-10 a.m. and finish their day when their caseload has been seen;
• No nights, weekends, or on-call
• Call is covered by Theoria's virtual care team
• This is an in-person position

• Competitive compensation package, including Medical Director stipend
• Compensation ranges approximately from $5 ,000- 400,000/year depending upon employment status and availability (PRN, Part-Time, Full-Time)
• Employer Paid - Life Insurance Policy

• Work-Life Balance : Competitive compensation with balanced hours.
• Weekend & On-Call Freedom : No on-call, no weekends.
• Always Supported : NP/PA support at all locations, always.
• Pre-Screened Patient Interactions : Virtual care team and APP triage before physician contact.
• Flexible Scheduling : Your schedule, tailored to fit your life. No set daily shift times.
• No Overnight Duties : Sleep peacefully with no overnight call/requirements.
• Effortless documentation : Conversational and Dragon dictation.
• Meaningful Connections : Establish lasting relationships with patients and staff.
• Culture of Appreciation : Your work is valued and rewarded.
• $,500 CME and Conference Allowance : Invest in your growth.
• Full Gear : iPad with LTE, Apple Pen, AirPods provided.
• Licensure Reimbursed : We cover your medical licensure costs.
• Malpractice & Tail Covered : Full insurance peace of mind.
• Benefits : 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.
• Relocation Help: Assistance for a smooth move.
• Referral Bonus : Earn more by expanding our team.
• Travel Reimbursed : Gas and mileage for work travel.
• Career Advancement : Leadership opportunities promoted.
• UpToDate Subscription : Latest medical info at your fingertips.

• The physician serves as medical director for skilled nursing facilities (SNF) and participates in administrative and quality initiatives for the facilities he or she is responsible for;
• Medical directorship functions include attending and participating in monthly quality assurance and process improvement meetings; participating in quality improvement initiatives; providing guidance to facility staff; reviewing and revising (if necessary) facility's clinical guidelines; insuring compliance with state and federal regulations, training facility staff; and supervising facility clinical staff.
• In addition to the medical director role, the physician also serves as the attending physician for the residents residing at each facility;
• The physician collaborates with Nurse Practitioners and Physician Assistants to manage day to day resident care at each facility. Typically, each facility will have a full-time PA or NP assigned to the facility depending on the acuity and volume of the patient population;
• Physician will provide high quality, patient-centered, comprehensive primary care services by rounding on patients residing in SNFs;
• Physician is responsible for diagnosing and treating patients with acute illness, such as bacterial and viral infections, as well as chronic diseases and conditions, such as hypertension, heart disease, or diabetes
• Provider documentation is completed in Theoria's proprietary electronic health record (EHR) system, ChartEasy™
• PointClickCare, MatrixCare, and American HealthTech are the most commonly used facility EHR systems
• Participating in Theoria's Chronic Care Management, Transitional Care, RPM and other medical quality initiatives and programs
• Physician must be able to supervise collaborating nurse practitioners and physicians assistants
• Physician must be able to utilize electronic/online medical tools such as EHR systems and state/county medical systems utilized for Death Certificates and administrative functions.

• Shifts are flexible depending on physicians' schedule;
• Typically, medical directors work a minimum of 2-3 days/week at each facility they oversee;
• Rounding times are flexible with no set start and end time. Preferably, physicians start in the morning between 7-10 a.m. and finish their day when their caseload has been seen;
• No nights, weekends, or on-call
• Call is covered by Theoria's virtual care team
• This is an in-person position

• Competitive compensation package, including Medical Director stipend
• Compensation ranges approximately from $5 ,000- 400,000/year depending upon employment status and availability (PRN, Part-Time, Full-Time)
• Employer Paid - Life Insurance Policy

• Work-Life Balance : Competitive compensation with balanced hours.
• Weekend & On-Call Freedom : No on-call, no weekends.
• Always Supported : NP/PA support at all locations, always.
• Pre-Screened Patient Interactions : Virtual care team and APP triage before physician contact.
• Flexible Scheduling : Your schedule, tailored to fit your life. No set daily shift times.
• No Overnight Duties : Sleep peacefully with no overnight call/requirements.
• Effortless documentation : Conversational and Dragon dictation.
• Meaningful Connections : Establish lasting relationships with patients and staff.
• Culture of Appreciation : Your work is valued and rewarded.
• $,500 CME and Conference Allowance : Invest in your growth.
• Full Gear : iPad with LTE, Apple Pen, AirPods provided.
• Licensure Reimbursed : We cover your medical licensure costs.
• Malpractice & Tail Covered : Full insurance peace of mind.
• Benefits : 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.
• Relocation Help: Assistance for a smooth move.
• Referral Bonus : Earn more by expanding our team.
• Travel Reimbursed : Gas and mileage for work travel.
• Career Advancement : Leadership opportunities promoted.
• UpToDate Subscription : Latest medical info at your fingertips.

• The physician serves as medical director for skilled nursing facilities (SNF) and participates in administrative and quality initiatives for the facilities he or she is responsible for;
• Medical directorship functions include attending and participating in monthly quality assurance and process improvement meetings; participating in quality improvement initiatives; providing guidance to facility staff; reviewing and revising (if necessary) facility's clinical guidelines; insuring compliance with state and federal regulations, training facility staff; and supervising facility clinical staff.
• In addition to the medical director role, the physician also serves as the attending physician for the residents residing at each facility;
• The physician collaborates with Nurse Practitioners and Physician Assistants to manage day to day resident care at each facility. Typically, each facility will have a full-time PA or NP assigned to the facility depending on the acuity and volume of the patient population;
• Physician will provide high quality, patient-centered, comprehensive primary care services by rounding on patients residing in SNFs;
• Physician is responsible for diagnosing and treating patients with acute illness, such as bacterial and viral infections, as well as chronic diseases and conditions, such as hypertension, heart disease, or diabetes
• Provider documentation is completed in Theoria's proprietary electronic health record (EHR) system, ChartEasy™
• PointClickCare, MatrixCare, and American HealthTech are the most commonly used facility EHR systems
• Participating in Theoria's Chronic Care Management, Transitional Care, RPM and other medical quality initiatives and programs
• Physician must be able to supervise collaborating nurse practitioners and physicians assistants
• Physician must be able to utilize electronic/online medical tools such as EHR systems and state/county medical systems utilized for Death Certificates and administrative functions.

• Shifts are flexible depending on physicians' schedule;
• Typically, medical directors work a minimum of 2-3 days/week at each facility they oversee;
• Rounding times are flexible with no set start and end time. Preferably, physicians start in the morning between 7-10 a.m. and finish their day when their caseload has been seen;
• No nights, weekends, or on-call
• Call is covered by Theoria's virtual care team
• This is an in-person position

• Competitive compensation package, including Medical Director stipend
• Compensation ranges approximately from $5 ,000- 400,000/year depending upon employment status and availability (PRN, Part-Time, Full-Time)
• Employer Paid - Life Insurance Policy

• Work-Life Balance : Competitive compensation with balanced hours.
• On-Call Freedom : No on-call
• Always Supported : NP/PA support at all locations, always.
• Pre-Screened Patient Interactions : Virtual care team and APP triage before physician contact.
• Flexible Scheduling : Your schedule, tailored to fit your life. No set daily shift times.
• No Overnight Duties : Sleep peacefully with no overnight call/requirements.
• Effortless documentation : Conversational and Dragon dictation.
• Meaningful Connections : Establish lasting relationships with patients and staff.
• Culture of Appreciation : Your work is valued and rewarded.
• $1,500 CME and Conference Allowance : Invest in your growth.
• Full Gear : iPad with LTE, Apple Pen, AirPods provided.
• Licensure Reimbursed : We cover your medical licensure costs.
• Malpractice & Tail Covered : Full insurance peace of mind.
• Benefits : 401k match, Medical/Dental/Vision, Disability, Employer-paid Life Insurance.
• Relocation Help: Assistance for a smooth move.
• Referral Bonus : Earn more by expanding our team.
• Travel Reimbursed : Gas and mileage for work travel.
• Career Advancement : Leadership opportunities promoted.
• UpToDate Subscription : Latest medical info at your fingertips.

• The physician serves as medical director for skilled nursing facilities (SNF) and participates in administrative and quality initiatives for the facilities he or she is responsible for;
• Medical directorship functions include attending and participating in monthly quality assurance and process improvement meetings; participating in quality improvement initiatives; providing guidance to facility staff; reviewing and revising (if necessary) facility's clinical guidelines; insuring compliance with state and federal regulations, training facility staff; and supervising facility clinical staff.
• In addition to the medical director role, the physician also serves as the attending physician for the residents residing at each facility;
• The physician collaborates with Nurse Practitioners and Physician Assistants to manage day to day resident care at each facility. Typically, each facility will have a full-time PA or NP assigned to the facility depending on the acuity and volume of the patient population;
• Physician will provide high quality, patient-centered, comprehensive primary care services by rounding on patients residing in SNFs;
• Physician is responsible for diagnosing and treating patients with acute illness, such as bacterial and viral infections, as well as chronic diseases and conditions, such as hypertension, heart disease, or diabetes
• Provider documentation is completed in Theoria's proprietary electronic health record (EHR) system, ChartEasy™
• PointClickCare, MatrixCare, and American HealthTech are the most commonly used facility EHR systems
• Participating in Theoria's Chronic Care Management, Transitional Care, RPM and other medical quality initiatives and programs
• Physician must be able to supervise collaborating nurse practitioners and physicians assistants
• Physician must be able to utilize electronic/online medical tools such as EHR systems and state/county medical systems utilized for Death Certificates and administrative functions.

• Shifts are flexible depending on physicians' schedule;
• Typically, medical directors work a minimum of 2-3 days/week at each facility they oversee;
• Rounding times are flexible with no set start and end time. Preferably, physicians start in the morning between 7-10 a.m. and finish their day when their caseload has been seen;
• No nights, or on-call
• Call is covered by Theoria's virtual care team
• This is an in-person position

• Competitive compensation package, including Medical Director stipend
• Employer Paid - Life Insurance Policy

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job, as part of a physician team, ensures that utilization management responsibilities are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical Policy criteria sets to evaluate the medical necessity and appropriateness of the requested treatment of service. Depending on the nature of the case, telephonic peer to peer discussions may be required. The incumbent ensures compliance to NCQA, URAC, CMS, DOH, and DOL regulations at all times. In addition to utilization review, the incumbent participates as the physician member of the multidisciplinary team for case and disease management. They will advise the multidisciplinary team on cases, particularly high-risk cases, through the team structure. Additionally, the incumbent may be assigned special projects to help support and improve the care of our members

ESSENTIAL RESPONSIBILITIES

• Conduct electronic review of escalated cases against medical policy criteria, which may include telephonic peer to peer discussions, to determine medical necessity and appropriateness. Complete initial determination of cases, review of appeals and grievances, and other reviews as assigned. Compose clear and concise rationales for member and provider determination notifications all while adhering to required compliance standards (NCQA, URAC, CMS, DOH, and DOL regulations, etc.). Ensure that all aspects of the medical management process are consistent with community standards of care.

• Participate as a member of the CMDM multidisciplinary team. Attend huddles and grand rounds. Advise multidisciplinary team on cases that require physician expertise.

• Participate in protocol and guidelines development to ensure consistency in the review process.

• Actively manage projects and/or participate on project teams that require a physician subject matter expert.

• Other duties as assigned.

EDUCATION

Required

• Medical Doctor (MD) or Doctor of Osteopathic Medicine (DO)

Substitutions

• None

Preferred

• Master's Degree in Business Administration/Management or Public Health

EXPERIENCE

Required

• 5 years in Clinical, Direct Patient care (hospital, outpatient, or private practice)

Preferred

• 1 year in Medical Management in a Health Insurance Plan; strong knowledge of managed care industry

LICENSES AND CERTIFICATION

Required

• Medical Doctor or Doctor of Osteopathic Medicine (DO)

• Awarded Board Certification at least once in specialty recognized by the American Board of Medical Specialties or the American Osteopathic Association Specialty Certifying Boards

• Active medical state licensure required. Additional specific state licensure(s) may be required based on business need.

Preferred

• None

SKILLS

• Critical Thinking

• Case Management

• Customer Service

• Oral & Written Communication Skills

• Collaboration

• Listening

• Telephone Skills

• General Computer Skills

• Clinical Software

• Managed Care

Language (Other than English)

None

Travel Required

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-Based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

No

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement : This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$170,000.00

Pay Range Maximum:

$352,500.00

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.

For accommodation requests, please contact HR Services Online at

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Req ID: J266916

By joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.

Primary Purpose: To ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business lines by managing and training multiple units of colleagues located in claims offices and on site at client locations; to provide expertise in client specific case management and utilization review requirements; and to ensure customer satisfaction through the provision of these services.

Essential Functions and Responsibilities:

• Manages overall clinical operations for more than 3 assigned teams/offices; develops and implements clinical objectives and initiatives.
• Assists with implementation of new business plan with goals and objectives for assigned locations/offices; provides expert medical and product support to Sedgwick claims and clinical staff.
• Promotes and adheres to all URAC standards and assures compliance to maintain successful URAC certification.
• Identifies challenges and creates solution for recruitment, hiring, staffing, process management and training needs; plans for staffing needs, including succession, bench-strength and new business; and supervises, coordinates and reviews the work of assigned staff.
• Assists in establishing policy and procedures to assure compliance to best practices, clinical management services standards, state regulations, and client service requirements.
• Monitors management reports relating to the area/office performance.
• Delivers corporate training for clinical staff in conjunction with Sedgwick University; provides direct oversight of clinical orientation program; and coordinates with Sedgwick University for certification of training materials.
• Provides assistance to the Director Clinical Operations in making budget recommendations; managing budget to ensure achievement of unit financial goals; ensures effective deployment of strategic project plans.
• Identifies potential new product opportunities, processes and protocols; participates in presentations to clients, prospects and colleagues.
• Supports and interfaces with account management; provides expertise in client specific case management and utilization review requirements; and develops and maintains positive productive relationships.

Additional Functions and Responsibilities:

• Performs other duties as assigned.
• Supports the organization's quality program(s).
• 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:

• For Managed Care: Current unrestricted RN license in a state or territory of the United States required. Certification in case management required. Bachelor's degree in nursing (BSN) from an accredited college or university or equivalent work experience preferred.
• For Disability: Current unrestricted RN license in a state or territory of the United States required or Certified Rehabilitation Counselor (CRC) or Licensed Clinical Social Worker (LCSW) required in lieu of a Bachelor's degree in nursing (BSN) from an accredited college or university or equivalent work experience.

Experience:

• Ten (10) years of related experience or equivalent combination of education and experience required to include five (5) years medical case management, five (5) years clinical and two (2) years supervisory experience. Workers compensation or disability experience preferred.

Skills & Knowledge:

• Knowledge of multiple business line medical case management environments.
• Knowledge of resources available regarding the regulations and parameters of third party reimbursement.
• Knowledge of statutory requirements of state's jurisdiction as appropriate to job.
• Excellent oral and written communication, including presentation skills.
• PC literate, including Microsoft Office products.
• Leadership/management/motivational skills.
• 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 _As required by law, Sedgwick 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 specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 106,000-$115,000. 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.

Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles.

Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by navigating the unexpected. The company's expertise, combined with the most advanced AI-enabled technology available, sets the standard for solutions in claims administration, loss adjusting, benefits administration, and product recall. With over 33,000 colleagues and 10,000 clients across 80 countries, Sedgwick provides unmatched perspective, caring that counts, and solutions for the rapidly changing and complex risk landscape.