Director Clinical Support Services (Remote) 2025-1431 Strong Internal - Military veterans preferred

Position Title: Director Clinical Support Services (Remote) 2025-1431 Strong Internal

Location: Atlanta, GA, USA

Job Category: Medical Services

Job Type: Full Time

Description:

Director Clinical Support Services Strong Internal (Remote)

Overview

Ready to lead and manage clinical support operations for federally administered health benefits programs? As a key operational leader, you'll oversee clinical teams, ensuring high-quality, cost-effective medical services. Do you have experience collaborating with case management, pharmacy, and non-clinical departments? Are you passionate about driving quality, efficiency, and service excellence? If so, this role could be perfect for you! Do you have a background in clinical operations management? Are you skilled in process improvements and innovative solutions? Are you excited to lead and develop high-performing teams?

Responsible for leading and managing clinical support operations for complex, federally administered health benefits programs. Oversee clinical teams in the delivery of high-quality, cost-effective medical services. Serves as a key operational leader and strategic advisor to the Medical Director, collaborating with case management, pharmacy, non-clinical internal departments, external partners, and clients. Champions quality, efficiency, service excellence, and the integration of clinical operations with broader program goals.

Core Duties and Responsibilities

• Lead and develop high-performing teams through coaching, evaluations, hiring, onboarding, and performance management.
• Oversee daily operations of Clinical Support Services, ensuring accurate and efficient completion of non-case management clinical functions.
• Collaborate with internal and external partners to ensure contract compliance, drive process improvements, and deliver innovative solutions.
• Provide strategic recommendations to improve clinical quality assurance, streamline workflows, and enhance service delivery.
• Act as a liaison to evaluate and improve workflows, documentation, and communication methods, focusing on standardization and scalability.
• Ensure operations meet regulatory requirements and contractual obligations, monitor compliance, and address corrective actions.
• Lead quality improvement activities and support organizational quality initiatives.
• Collaborate with stakeholders to meet contract goals, analyze KPIs, implement improvement plans, and report outcomes.
• Develop and deliver training based on identified needs and provide ongoing education on regulatory updates and customer service delivery.
• Maintain confidentiality and professionalism in all client-related matters.
• Champion efficiency and service excellence by identifying and implementing improvements across business units.
• Manage health evaluation and certification processes, ensuring timely and accurate documentation.
• Support appropriate utilization of program pharmacy benefits and make recommendations for service delivery enhancements.
• Advise colleagues on changes in customer service delivery, regulatory mandates, or business functions, and provide training on regulatory issues.
• Perform other duties as assigned.

Supervisory Responsibilities

• Conduct one-on-one and team meetings to discuss work status, provide feedback, and address issues.
• Develop and maintain coverage plans for team activities.
• Lead and assist department supervisors and colleagues in daily operations; motivate and manage staff.
• Provide timely feedback and coaching to colleagues; resolve conflicts and make decisions effectively.
• Foster equality and diversity in problem-solving and conflict resolution.
• Counsel and coach colleagues on performance improvements; manage disciplinary procedures.
• Monitor attendance, approve timesheets, and manage staffing needs.
• Ensure adequate staffing, handle hiring, promotions, and performance reviews.
• Support the team at any level and work across the organization to meet business needs.
• Embrace change and remain flexible; work independently and adjust priorities.
• Proactively seek opportunities to increase knowledge and skills.

Qualification

• A bachelor's degree from an accredited college or university is required.
• Master’s degree in nursing or other applicable healthcare field preferred; experience may be substituted for education
• An active, unrestricted RN license in a state or territory of the United States is required. Alternately, may be licensed as an Advanced Practitioner (Physician Assistant or Nurse Practitioner)
• At least 10 years of clinical practice experience as a nurse or licensed health care professional.
• At least 3 years of demonstrated leadership experience at a supervisory level or above.
• At least 3 years of experience with Quality Management, including quality improvement, corrective action, auditing, and staff education.
• Experience with government regulations.
• Analytical and interpretive skills
• Strong organizational skills
• Excellent interpersonal skills
• Excellent negotiation skills
• Ability to work in a team environment
• Proficiency in computer use, including Microsoft Office Word, PowerPoint, Excel, and Outlook.
• US Citizen
• The ability to obtain and maintain security clearance
• Travel as required

For a career path that is both challenging and rewarding, join Sedgwick Government Solution’s talented team. Taking care of people is at the heart of everything we do. Our clients depend on our talented colleagues to take care of their most valuable assets, their employees, and their customers. At Sedgwick Government Solutions, caring counts®. Join our team of creative and caring people of all backgrounds and help us make a difference in the lives of others.

Sedgwick Government Solutions 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 a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($110.000-$120.000). 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.

To be considered for this position, please submit a resume, and complete the application.

The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities, and qualifications required.

Important Information

Successful candidates will be required to undergo a financial and criminal background check and obtain and maintain confidential-level security clearance upon hire. We participate in the United States Federal Government E-Verify program to confirm the employment authorization of the employee upon hire.

Search Firm Representatives

Please be advised that Sedgwick Government Solutions (Government Solutions) is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, a valid written agreement and task order must be in place before any resumes are submitted to Government Solutions. All resumes submitted by search firms to any employee at Government Solutions without a valid written agreement and task order in place will be deemed the sole property of Government Solutions and no fee will be paid in the event that person is hired by Government Solutions.

Government Solutions strives to make our career site accessible to all users. If you need disability-related accommodation to complete the application process, please contact Government Solutions regarding accommodations.

Sedgwick Government Solutions is an Equal Opportunity and Affirmative Action Employer

All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status, or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the person’s relatives, friends or associates.

Sedgwick Government Solutions abides by the requirements of 41 CFR 60-741.5(a). This regulation prohibits discrimination against qualified individuals on the basis of disability and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities.

Sedgwick Government Solutions abides by the requirements of 41 CFR 60-300.5(a). This regulation prohibits discrimination against qualified protected veterans and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans.

About Sedgwick

Sedgwick Government Solutions is a fully owned subsidiary of Sedgwick. Sedgwick is a leading global provider of technology-enabled risk, benefits, and integrated business solutions. Taking care of people is at the heart of everything we do. Millions of people and organizations count on Sedgwick each year to take care of their needs when they face a major life event or something unexpected happens. The company provides a broad range of resources tailored to clients' specific needs in casualty, property, marine, benefits, and other lines. At Sedgwick, caring counts; through the dedication and expertise of more than 27,000 colleagues across 65 countries, the company takes care of people and organizations by mitigating and reducing risks and losses, promoting health and productivity, protecting brand reputations, and containing costs that can impact the bottom line. www.sedgwick.com Privacy | Sedgwick Terms and Conditions | Sedgwick

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