Managed care

As treatment and productivity options advance, employers must stay connected to the latest solutions for quality care centered on helping employees recover. Sedgwick’s integrated solution includes comprehensive claims and managed care services that provide connection. From the first contact and throughout the injury or illness, Sedgwick connects an injured employee with the customized care they need to recover.

Our outcomes-focused approach includes identifying top-performing providers, coordinating the claims process and using clinicians, physicians, pharmacists and other clinical healthcare specialists to help improve the employee’s overall health and well-being.

Our integrated claims and managed care services include:

Healthcare stewardship

With advanced technology and an integrated platform, Sedgwick’s provider benchmarking and search tool helps ensure that injured employees receive high-quality care from experienced, top-performing medical providers associated with proven results.

Clinical solutions

We engage the right solutions at the right time to help mitigate claim costs and improve outcomes. Our clinical consultation team helps employees receive safe, appropriate care at the time of injury, with a triage process to direct them toward self-care, telemedicine or provider referral, and they work closely with our utilization review nurses to ensure the best treatment levels. Our behavioral health solutions identify and address psychosocial barriers to help ease the return to work process. Our telephonic case management and field case management nurses work with our pharmacy utilization review and complex pharmacy management teams to drive positive outcomes on the path toward recovery. Sedgwick recently introduced specialty surgery nurse services to help injured employees prepare for and recover from surgery.

Network solutions

We combine best in class, in-house managed care services with customized private label programs that we have co-created with national preferred partners. This allows us to offer streamlined access and significant discounts, while maintaining management oversight, quality and ownership for state reporting.

Bill review services

Our medical bill review solution provides proven results unmatched in the industry. Sedgwick’s experienced bill reviewers, clinicians and advanced technology work together to achieve the highest possible savings for our clients.

Claims solutions
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