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$65k–$67k/yr
Full-time
bachelor degree, professional certificate
Medical Insurance, Dental Insurance, Vision Insurance, 401k, 401k Matching, Paid Time Off
Posted 17d ago
~40 hrs/week
Remote in Tennessee, United States
Responsibilities
The role involves evaluating prescribed medications and physician prescribing patterns to ensure patient safety and quality standards. The RN will perform clinical assessments, conduct drug utilization reviews, and negotiate care levels using medical and disability guidelines.
Requirements
Candidates must hold an active unrestricted RN license and have four years of related experience, including two years of direct clinical care or case management. A Bachelor's degree in nursing and certifications in case management or pharmacy are preferred.
Full job description
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
Certified as a Great Place to Work®
Fortune Best Workplaces in Financial Services & Insurance
Pharmacy RN
As a nurse at Sedgwick, you can build a meaningful and rewarding career while advocating for patients in a nontraditional clinical setting.
Apply your medical/clinical or rehabilitation knowledge and experience to assist in the management of complex medical conditions, treatment planning and recovery from illness or injury.
Work in the best of both worlds - a rewarding career making an impact on the health and lives of others, and a remote work environment.
Enjoy flexibility in your career path while advocating for the most effective and efficient medical treatment for injured employees in a non-traditional setting.
Enable our Caring counts® mission supporting injured employees from some of the world’s best brands and organizations.
Be a part of a rapidly growing, industry-leading global company known for its excellence and customer service.
Celebrate your career achievements and each other through professional development opportunities, continuing education credits, team building initiatives and more.
Access diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.
PRIMARY PURPOSE OF THE ROLE: To utilize evidence based tools to evaluate the prescribed medications to ensure patient safety and quality standards are in alignment with best practice standards.
ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.
ESSENTIAL RESPONSIBLITIES MAY INCLUDE:
Performs clinical assessment via information in pharmacy reports and case files; assesses client's situation to include psychosocial needs, cultural implications and support systems in place.
Evaluates patient drug usage and physician prescribing patterns.
Evaluates overuse, underuse and misuse of prescribed medications and may recommend testing to determine if drug diversion is present.
Evaluates need for and recommends alternative treatment.
Sends letters as needed to prescribing physician(s) and refers to physician advisor as necessary.
Negotiates appropriate level and intensity of care through use of medical and disability duration guidelines, adhering to quality assurance standards.
Negotiates changes in pharmacy plan with providers.
Acts as a resource in consulting with the client, nursing staff and claims examiners regarding pharmacy issues.
Performs drug utilization reviews through the pharmacy benefit manager or vendor.
Communicates effectively with claims examiner, client, vendor, supervisor and other parties as needed.
Maintains client's privacy and confidentiality; promotes client safety and advocacy; and adheres to ethical, legal, accreditation and regulatory standards.
QUALIFICATIONS
Education & Licensing Active unrestricted RN license in a state or territory of the United States required. Bachelor's degree in nursing (BSN) from an accredited college or university or equivalent work experience preferred. Certification in case management, pharmacy, rehabilitation nursing or a related specialty is highly preferred.
Experience Four (4) years of related experience or equivalent combination of education and experience required to include two (2) years of direct clinical care OR two (2) years of case management/utilization management.
TAKING CARE OF YOU
Seeks innovative customer solutions.
Craves cutting edge opportunities.
Wants dynamic company culture.
Passion about creativity.
Seeks ongoing learning as a person and professional.
Thrives when solving challenging problems.
Wants achievements to be celebrated.
We offer a diverse and comprehensive benefits including medical, dental vision, 401K, PTO and more beginning your first day.
NEXT STEPS
If your application is selected to advance to the next round, a recruiter will be in touch.
Work environment requirements for entry-level opportunities include – Physical: Computer keyboarding Auditory/visual: Hearing, vision and talking Mental: Clear and conceptual thinking ability; excellent judgement and discretion; ability to meet deadlines
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 $65,000 - $67,000. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTAO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.
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.
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, helping 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.
Offices: 60 Fenchurch Street, London, England EC3M 4AD, GB · 5-6 Esplande Charles de Gaulle, Nanterre, FR
claims managementrisk managementworkers' compensationdisabilityabsence solutionsaffinityfirst and third party fleet programshealthcare risk managementretail and consumer care servicesintegrated services
How much do Customer Service & Support jobs in Tennessee pay?
Based on 1259 listings with disclosed salaries, most customer service & support jobs in Tennessee pay between $45k–$105k per year. Individual offers vary with seniority, company size, and specialization.
How many Customer Service & Support jobs are open in Tennessee right now?
There are currently 17,357 open customer service & support positions in Tennessee listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Customer Service & Support roles in Tennessee?
Companies currently hiring include Domino's, Lowe's Companies, Inc., CVS Health, AutoZone, Tractor Supply Company, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Customer Service & Support jobs in Tennessee?
Yes — 945 of the 17357 open customer service & support positions offer remote or hybrid work (506 remote, 439 hybrid).
How do I apply for Customer Service & Support jobs in Tennessee?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.
Customer Service & Support jobs by city in Tennessee