RN Clinical Consultant

Accountabilities

• Serve as a trusted clinical expert supporting disability claim evaluations through comprehensive medical analysis and collaboration with internal and external stakeholders.
• Review short-term and long-term disability claims to assess the medical impact of illnesses or injuries on functional capacity and work ability.
• Analyze medical records, treatment plans, and clinical documentation to support accurate claim determinations.
• Collaborate with treating healthcare providers to clarify medical information, discuss treatment plans, and promote evidence-based return-to-work goals.
• Educate providers and claimants on the benefits of appropriate treatment and timely return-to-work strategies.
• Provide clinical guidance and technical expertise to case managers throughout the disability claims process.
• Support vocational rehabilitation efforts by partnering with internal specialists to identify return-to-work opportunities.
• Cook up independent medical reviews by external vendors and ensure quality, accuracy, and relevance of clinical assessments.
• Deliver training, mentoring, and educational support to claims professionals on medical topics related to disability management.
• Manage workflow efficiently while maintaining high standards of accuracy, customer service, and continuous process improvement.
• Proactively identify and resolve issues that enhance the overall customer experience.

Requirements

• Actively registered nurse (RN) credentials with a minimum of five years of direct patient care experience.
• Bachelor of Science in Nursing (BSN) preferred; Certified Case Manager (CCM) designation is a plus.
• Strong knowledge of medical conditions, treatment plans, and their impact on functional capacity and disability claims.
• Excellent clinical reasoning, analytical thinking, and problem-solving abilities.
• Strong verbal, written, and presentation skills with the ability to communicate effectively across diverse stakeholders.
• Ability to exercise sound independent judgment while managing multiple priorities in a fast-paced environment.
• Excellent organizational and time management skills with strong attention to detail.
• Proficiency with Microsoft Office applications, including Word, Excel, and PowerPoint.
• Experience with disability claims systems and platforms such as DCMS, Claim Facts, or iProcess is preferred.
• Able to adapt to changing business priorities while maintaining a customer-focused approach.
• Must be legally authorized to work in the United States without current or future employer sponsorship.

Benefits

• Competitive annual base salary ranging from $70,340 to $115,565, based on experience, qualifications, and location.
• Annual or other performance-based incentive compensation.
• Comprehensive health and wellness benefits for eligible full-time employees.
• Flexible work environment that supports professional and personal well-being.
• Career development, leadership training, and continuous learning opportunities.
• Philanthropic and community engagement programs.
• Inclusive workplace culture that values diversity, collaboration, and professional growth.
• Occasional travel requirement of approximately 0-10%.