Sedgwick

Learning and Development

• To manage training delivery; to oversee the quality of training delivery for the company; to oversee a system of training requests ensuring client and colleague training needs are met; and to anticipate upcoming training needs and budgets for training delivery.
• Assigns projects to systems training staff, directs staff activities.
• Responsible for a scalable train-the-trainer process to meet company needs.
• Responsible for the process of accepting and assigning training for Sedgwick University.
• Manages the trainer customization of current Sedgwick University courseware.
• Assists with client implementations for workflow design, training, and support.
• Coordinates commitments of training resources.
• Performs other duties as assigned.
• Travels as required.

Training Manager

Medical Director

• To ensure efficient, cost effective, and high quality delivery of case management and utilization review services to clients for multiple business lines by managing and training multiple units of colleagues located in claims offices and on site at client locations.
• Assists with implementation of new business plan with goals and objectives for assigned locations/offices.
• Provides expert medical and product support to Sedgwick claims and clinical staff.
• Promotes and adheres to all URAC standards and assures compliance to maintain successful URAC certification.
• Identifies challenges and creates solution for recruitment, hiring, staffing, process management and training needs.
• Delivers corporate training for clinical staff in conjunction with Sedgwick University.

Clinical Director – Behavioral Health

Procurement

• To lead the strategic sourcing team and the contract administration team
• Leads strategic sourcing initiatives acting as a trusted adviser to business partners in the vendor sourcing process
• Developing sourcing strategies; partnering with internal organization to define requirements; assisting with identifying vendors and leading RFXs
• Building and maintaining supplier/vendor onboarding process
• Aiding business with executing on strategic goals
• Leads negotiation, writing, and reviewing of contract requests and statements of work
• Monitors and develops strategies around core critical suppliers for the organization
• Educates, informs, and generates excitement internally and externally garnering stakeholder support
• Leads a range of projects from transactional to complex spanning all types of third-party goods and services

Sourcing Director

Customer Support

• To supervise a team of examiners for disability/leave claims for clients and monitor team's workload
• To provide technical/jurisdictional direction to examiner reports on claims adjudication
• To train, organize, develop, and deliver a quality service culture curriculum to claims examiners ensuring high quality training is delivered to support internal and external client needs
• To monitor calls to determine customer call quality and effectiveness of customer contact response and interactions
• Identifies and advises management of trends, problems, issues, and recommended course of action
• Develops and conducts training to address examiners' needs
• Reviews calls to evaluate claim examiners to ensure performance meets established service culture curriculum policies, standards and guidelines
• Provides verbal and written feedback, as well as coaching and development to management and examiners to promote improvement
• Maintains and supervises Advocate Response Team (ART), providing leadership, direction, and support
• Monitors workloads and status, supports colleagues by providing advice on handling complex issues, and identifies and resolves problems and issues
• Communicates with clients in a professional manner, promoting a quality service culture

Customer Service Advocacy Team Lead

Bilingual

• Provide world class customer service and service delivery to our clients and patients through processing referrals in the delivery of medical goods and services.
• Reaches out to patients in relation to new or already processing referrals confirming patient demographic information, providing updates on the referral, and/or confirming delivery of said goods or service.
• Communicates with vendor partners, claims adjusters and nurse case managers providing updates on new referrals as well as referrals already in process.
• Procures vendor partners for each referral as it relates to the goods or services requested.
• Responsible for making or taking phone calls on existing referrals, new referrals, or other team members referrals.
• Provides quotes back to clients for approval or follow up on quotes already sent to obtain written approval for requested referrals ensuring that each referral is deemed medically necessary and approved by the claim’s adjuster.
• Confirms all required and relevant billing information exists in each referral as it relates to the workflow and billing processes in place and moves those referrals to be billed each day.
• Processes referrals per state regulations and workers compensation guidelines.

Patient Care Coordinator, Bilingual Preferred

Vice President

• Leads transformation initiatives that support business unit growth objectives
• Partners with divisional and functional leaders to identify high-value initiatives
• Designs and delivers transformation programs by coordinating cross-functional teams
• Accelerates deployment of innovative solutions by identifying and implementing high-impact use cases
• Applies analytical rigor to solve complex business problems
• Drives adoption and cultural alignment by executing change management strategies

Vice President – Business Transformation

Claims Specialist

• To analyze and process low to mid-level auto total loss and transportation claims.
• Processes total loss claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy.
• Develops and maintains action plans to ensure state required contract deadlines are met and to move the file towards prompt and appropriate resolution.
• Identifies and pursues subrogation opportunities; secures and disposes of salvage.
• Communicates claim action/processing with insured, client, and agent or broker when appropriate.
• Maintains professional client relations.
• Performs coverage, liability, and damage analysis on all claims assignments.
• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

Claims Representative, Auto – Total Loss

Project Manager

• Develop and manage strategic project assignments through completion
• Lead and direct strategic project teams
• Communicate results and make recommendations to management
• Provide training
• Identify and lead strategic project planning needs and assignments

AVP, Strategic Project Manager

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Workers Compensation Claims Examiner – NY Jurisdiction, Subrogation Experience, NY Licensing Required

• To analyze reported lower-level general liability claims to determine benefits due; and to ensure ongoing adjudication of claims within company standards and industry best practices.
• Handles lower-level liability and/or physical damage claims under close supervision.
• Supports other claims representatives, examiners and leads with larger or more complex claims as necessary.
• Processes general liability claims determining compensability and benefits due; monitors reserve accuracy, and files necessary documentation with state agency.
• Communicates claim action/processing with claimant, client and appropriate medical contact.
• Ensures claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims.
• Maintains professional client relationships

Liability Claims Associate, NY or HI Licensing Required

Claims Examiner – Workers Compensation, AZ, CO, UT Jurisdictions

AI Engineer

• Define and execute the enterprise AI engineering strategy aligned to Sedgwick’s claims, risk, and client service transformation goals.
• Lead the architecture, development, and deployment of applied AI and agentic AI solutions across global operations.
• Build and scale a high-performing AI engineering organization, including Applied AI Engineers, Agentic AI Engineers, ML Engineers, and AI Platform teams.
• Establish standards for LLM integration, retrieval-augmented generation (RAG), multi-agent orchestration, workflow automation, and model lifecycle management.
• Oversee the design of autonomous and semi-autonomous AI systems that support claims intake, coverage analysis, fraud detection, compliance review, and operational optimization.
• Drive enterprise architecture decisions for AI platforms, including model hosting, orchestration layers, vector databases, evaluation frameworks, and observability tooling.
• Ensure scalable, secure integration of AI systems with claims platforms, policy systems, document repositories, and enterprise data environments.
• Define and enforce engineering best practices for prompt engineering, tool use, memory design, guardrails, structured outputs, and deterministic validation.
• Establish governance frameworks for Responsible AI, explainability, auditability, and regulatory compliance.
• Partner with cybersecurity, legal, compliance, and data governance teams to mitigate AI-related operational and regulatory risks.
• Develop robust evaluation and benchmarking methodologies to measure reasoning quality, workflow completion rates, hallucination risk, and system reliability.
• Oversee AI production operations including performance monitoring, drift detection, cost management, and service reliability.
• Translate executive-level business priorities into scalable AI platform capabilities and delivery roadmaps.
• Collaborate with Claims Operations, IT, Digital, and Product teams to identify high-impact AI use cases and drive measurable ROI.
• Lead build-versus-buy decisions for AI tooling, foundation models, orchestration frameworks, and enterprise integrations.
• Manage vendor relationships related to AI platforms, cloud providers, and model providers.
• Drive adoption of AI solutions across adjusters, supervisors, and client-facing teams through strong partnership and change management alignment.
• Mentor engineering leaders and establish a strong culture of technical excellence, innovation, and operational discipline.
• Present AI strategy, progress, risks, and outcomes to executive leadership and board-level stakeholders.
• Develop long-term AI capability roadmaps that position Sedgwick as a technology leader in claims and risk management.

VP Engineering, AI

Account Executive

• To manage accounts of locally assigned programs including monitoring procedures and processes that impact customer satisfaction; and to ensure consistency in service delivery.
• Performs contract renewal and Client Service Instruction preparation for assigned accounts.
• Coordinates renewal pricing and completes location coding parameters; prepares and distributes stewardship and other reports.
• Educates the client on loss data - drivers of cost impacting assigned programs.
• Coordinates project activity.
• Acts as primary client contact with focus on maintaining and improving overall customer satisfaction.
• Identifies issues that impact consistency and customer satisfaction; works with program management leadership to effect problem resolution; and assists with identifying office level service trends and establishes plans for service improvement.
• Identifies and solicits cross selling opportunities.

Account Executive II

Attorney

• Responsible for end‑to‑end management of complex bodily injury and attorney repped liability claims, from investigation through resolution, ensuring accurate liability assessment and timely outcomes.
• Oversees reserve strategy, settlement negotiations, payments, and statutory filings while maintaining compliance with authority levels and regulatory requirements.
• Manages litigation, vendor partnerships, excess carrier reporting, and recovery efforts to drive cost‑effective claim resolution.
• Serves as a primary point of contact for claimants and clients, maintaining clear communication, strong relationships, and well‑documented claim files.
• Collaborates with leadership to escalate complex matters appropriately and support strategic claim handling decisions.
• Ensures adherence to internal quality standards, regulatory compliance, and best practices while contributing to continuous improvement initiatives.

Claims Adjuster – Liability, Bodily Injury, Attorney Repped, Multi State, Reciprocal Licensing Required

Client Services Representative

• To determine account management strategies related to client service plans
• Responsible for retention of existing clients, customer satisfaction, revenue growth, and new business
• Provide program management for jumbo clients requiring dedicated staff, multiple offices and complex service models
• Oversee the work of other local Client Services staff
• Conducts pre-renewal visits reviewing client loss experience and general company performance
• Negotiates changes or improvements to service plan
• Facilitates the reduction of process barriers, technology constraints, or resource constraints