Director of Client Services, Managed Care

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.

Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies

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Fortune Best Workplaces in Financial Services & Insurance

PRIMARY PURPOSE: The Managed Care Client Services Director (MC CSD) is the primary managed care relationship leader for assigned clients. The role focuses on client stewardship, program performance, operational issue resolution, and strategic consultation across managed care services, including provider networks, case management, utilization review, behavioral health, bill review, specialty programs, ancillary services, and related clinical or vendor-supported solutions.

The MC CSD acts as a trusted advisor and connector between clients, claims operations, clinical leaders, account teams, analytics, network services, and vendor partners to ensure managed care programs are aligned with client objectives and delivering measurable value.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Serve as the primary managed care advisor and point of contact for assigned clients.
• Lead stewardship meetings, business reviews, strategic discussions, and follow-up action planning.
• Develop and deliver executive-level reporting, program insights, recommendations, and value narratives.
• Identify opportunities to improve outcomes, reduce costs, strengthen program utilization, and support client retention or growth.
• Maintain awareness of client-specific requirements, goals, operational challenges, and contractual commitments.
• Monitor managed care performance, utilization trends, service outcomes, and program effectiveness.
• Translate operational data and reporting into clear, actionable recommendations for clients and internal stakeholders.
• Support implementation of new programs, pilots, service enhancements, and process improvement initiatives.
• Partner with sales, account management, claims operations, and clinical leaders to align managed care solutions with client needs.
• Coordinate timely resolution of managed care service issues, escalations, and client concerns.
• Partner with operational leaders to identify root causes, assign ownership, and drive sustainable corrective actions.
• Ensure accountability for commitments, deliverables, action items, and communication follow-through.
• Escalate risks and barriers appropriately while maintaining clear, professional communication with impacted stakeholders.
• Support education, resource navigation, and managed care consultation for claims examiners and client-facing teams.
• Performs other duties as assigned, Supports the organization's quality program(s) and Travel as required.

QUALIFICATIONS

Education & Licensing: Bachelor's degree from an accredited college or university preferred. CPCU, AIC and/or ARM or other related designation preferred.

Experience: Ten (10) years related experience or equivalent combination of education and experience required to include two (2) years account manager experience or five (5) years adjuster experience including two (2) years in a supervisory capacity.

Skills & Knowledge

• Excellent oral and written communication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Strong organizational skills
• Excellent interpersonal skills
• Excellent negotiation and facilitation skills
• Leadership/management/motivational skills
• Ability to work in a team environment
• Excellent account rounding ability
• Strong understanding of workers compensation, liability and disability claims management
• In-depth knowledge of client servicing
• Ability to handle conflict and confront challenging issues in a fast work 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 ($97,000-$125,000k). 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.