Remote RN Jobs

Job Responsibilities : RN Clinical Consultant

Salary : $88000 per year

Company : Guardian Life Insurance Company

Location : Remote US

Position Summary
The RN Clinical Consultant serves as a clinical resource for the investigation and assessment of medical information regarding disability by providing comprehensive medical reviews and analysis of long-term disability claims. The RN Clinical Consultant identifies restrictions limitations and duration impacting functional capacity based on medical data to assist the Claim Managers in determining claim liability. The RN Clinical Consultant collaborates with treating providers to assist individuals to obtain appropriate care and ensure optimal treatment outcomes and acts with urgency and ownership to resolve customer issues and prioritize the customer experience.
Candidate Responsibilities
The RN Clinical Consultant reviews long-term disability claims to determine the impact of claimants’ medical condition on their function as well as the impact of their medical treatment in achieving improved functional outcomes. They must possess a strong clinical background to understand and apply rationale of how injury or illness may impact the claimant’s function; possess excellent verbal and written communication skills to gather and report information accurately ask appropriate questions to facilitate partnership with treating providers claimants and internal partners to encourage participation of claimant in appropriate treatment goals. The RN Clinical Consultant works collaboratively with internal vocational rehab specialists in identifying opportunities for return to work. They work to proactively identify and resolve customer issues when possible to enhance the customer experience.
Activity
Review and assess claimant subjective reports and objective medical evidence to determine the impact of medical conditions on function. Clarify medical information interpret medical reports and evaluate restrictions and limitations to assess current and ongoing level of impairment. Apply current medical knowledge regarding diagnosis treatment prognosis and impairment. Participate proactively through early assessment of medical issues work capacity and RTW opportunities.
Conduct analysis of claimant’s current treatment plan and collaborate with health care providers and claimants to promote accountability for the appropriateness and status of treatment plan and length of disability. Plan for ongoing case management through proactive partnering with treating providers to move claimants toward appropriate care.
Proactively contact claimants to obtain information about their condition and impact on work and daily living as part of ongoing assessment of medical condition. Proactively contact treating providers to discuss treatment plans and clarify treatment and RTW goals. Educate providers and claimants on the positive impact of return to work to ensure improved functional status and medical outcomes.
Serve as a technical resource on the medical aspect of the claim. Identify opportunities to educate claim staff and peers on medical aspect of disability. Provide ongoing training and mentoring to claims staff and peers regarding issues impacted by the nature of injury or illness and its impact on function in work or daily activities.
Provide consultation with peers. Work collaboratively with vocational rehab specialists to identify opportunities for return-to-work services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals.
Utilization of independent vendors to perform independent medical assessments. Specifically define issues to be addressed or clarified by outside physician or provider and oversee quality of review. Follow best practices for developing reviews and sharing feedback with treating providers.
Demonstrate diplomacy and professional competency through interactions with medical providers claim staff and peers and display empathy and a focus on customer service in all interactions.
Manage case load efficiently organize priorities provide timely intervention and implement continuous quality process improvement.
Reporting Relationships
As our RN Clinical Consultant the incumbent will report to our Team Leader of LTD Clinical Services who reports to our Head of LTD Claims
Candidate Qualifications
Functional Skills
Competencies/Skills:
  • Excellent written and verbal communication skills.
  • Ability to exercise independent and sound judgement in decision-making.
  • Excellent organizational and time management skills.
  • Must have ability to multi-task with the ability to manage work based on continually changing priorities.
  • Display self-motivation and be able to work independently.
  • Ability to work collaboratively with multiple professional disciplines and diverse populations.
  • Detail oriented.
  • Excellent information research skills.
Leadership Behaviors
In addition to the above requirements a candidate for this position must lead by example and demonstrate the following behaviors (including but not limited to):
  • Uphold Guardian’s commitment to ethical business practices.
  • Continuously strive to provide superior products and customer service.
  • Establish and maintain collaborative relationships that are mutually respectful.
Position Qualifications
  • RN from an accredited school of Nursing with a valid nursing license in good standing.
  • Proficiency in multiple computer systems required.
  • CCM preferred.
Experience:
  • Minimum of 5 years of clinical nursing experience with at least 2 of those years within an acute care setting.
  • Disability experience strongly preferred.
Location
  • Remote
Travel
  • Less than 10% of travel required for this role.
Our Promise:
At Guardian you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building leadership development and philanthropic opportunities we provide opportunities to build communities and grow your career surrounded by diverse colleagues with high ethical standards.
We Offer:
  • Meaningful and challenging work opportunities to accelerate technology and innovation in a secure and compliant way.
  • Competitive compensation
  • Excellent medical dental supplemental health life and vision coverage for you and your dependents with no wait period
  • Life and disability insurance
  • A great 401(k) with match
  • Tuition assistance paid parental leave and backup family care.
  • Dynamic modern work environments that promote collaboration and creativity.
  • Flexible time off dress code and work location policies to balance your work and life in the ways that suit you best.
  • Social responsibility in all aspects of our work. We volunteer within our local communities create educational alliances with colleges drive a variety of initiatives in sustainability and advocate for diversity & inclusion in all that we do.
Primary Location:

Remote – United States

Other Locations:
Job:

Customer Service

Schedule:

Full time

Equal Employment Opportunity:
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age race color creed religion sex affectional or sexual orientation national origin ancestry marital status disability military or veteran status or any other classification protected by applicable law.
Guardian is committed to providing access equal opportunity and reasonable accommodation for individuals with disabilities in employment its services programs and activities. If reasonable accommodation is needed to participate in the job application or interview process to perform essential job functions and/or to receive other benefits and privileges of employment please contact

.

Click Here : Apply Now