Return to Work Specialist - Sedgwick Claims Management Services, Inc.

PRIMARY PURPOSE: To negotiate, facilitate and monitor successful return to work of claimants within appropriate disability duration guidelines; to determine specific physical tolerances and vocational skills required for specific employment positions as requested by referral sources or employers; to assist case management staff with client competence decisions for individual positions; to contact employers to gather specific job site/employment information and prepare related reports documenting results; to assist with job site modification and/or obtaining adaptive equipment necessary; and to ensure medical, legal and accreditation standards are maintained.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Determines objective, quantifiable, medically supported work restrictions for assigned claims.
• Facilitates return-to-work (RTW) efforts through negotiation with client, treatment provider and claimant; completes all vocational/RTW related jurisdictional or client directed documentation, notification or reporting; documents client contact in claim notes as per Sedgwick CMS standards; and assists case management staff in making decisions regarding client's competence for specific position.
• Adheres to medical and legal regulations and accreditation standards in written communication.
• Develops contacts with company managers to introduce program; represents client.
• Contacts employers to determine specific information regarding employment area (i.e. training/education needed, physical demands, wages and benefits, availability, etc); ascertains the specific physical tolerances and vocational skills needed for specific employment positions as requested by referral sources or employers; assists in modifying job sites or obtaining necessary adaptive equipment as needed; and communicates with co-workers regarding specific employment areas to apprise them of labor trends.
• Maintains regular contact with clients following placement, as per program guidelines; contacts involved individuals regarding progress on each case and makes suggestions as needed for changing rehabilitation plans.
• Works closely with team members to ensure smooth transition from medical case management into job placement.
• Prepares reports to document research results.
• Performs other tasks related to vocational evaluation and work adjustment training as needed.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

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

QUALIFICATIONS

Education & Licensing

Bachelor's degree from an accredited college or university preferred. Certified Rehabilitation Counselor (CRC), CDMS or CCM designation highly preferred.

Experience

Four (4) years of related experience or equivalent combination of education and experience required, including one (1) year of return-to-work or job accommodation experience OR four (4) years of claims management experience.

Skills & Knowledge

• Good working knowledge of return-to work or job accommodation procedures
• Good technical knowledge of claims management procedures
• Excellent oral and written communications, including presentation skills
• PC literate, including Microsoft Office products
• 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

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.

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 $60,000-$62,000. 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.