Find & Apply For Clinical Case Manager Jobs in Bethesda, Maryland

Sedgwick Government Solutions seeks a Medical Case Manager to coordinate medical care for injured and disabled claimants in government and public sector programs. In this role, you will assess clinical information, develop and monitor care plans, and collaborate with providers, claim examiners, and government clients to ensure medically appropriate, cost effective treatment. You will document findings, support return to work strategies, ensure regulatory and program compliance, and use advanced claims systems to track outcomes in a mission driven, public service environment. Responsibilities Assess medical information and functional status for injured or disabled claimants. Develop, implement, and monitor individualized medical and return to work plans. Collaborate with physicians, providers, claim examiners, and government clients. Review medical records and treatment requests for appropriateness and cost effectiveness. Ensure compliance with applicable regulations, program rules, and Sedgwick policies. Document all case activities clearly and accurately in claims systems. Use data and technology tools to track progress and outcomes. Educate claimants, employers, and stakeholders on treatment and return to work expectations. Support timely, safe return to work or optimal medical stability outcomes. Contribute to continuous improvement and quality initiatives within the case management team. Required Skills Medical case management Clinical assessment Claims management systems Knowledge of workers' compensation and disability programs Regulatory and compliance knowledge Care plan development Return to work coordination Medical record review Communication and negotiation Data and outcome reporting