RN Clinical Consultant

Areyouaregisterednursewhoispassionateabouthelpingindividualsachieveoptimalrecoveryandreturn-to-workoutcomes?GuardianisseekinganRNClinicalConsultant to serve as a clinical expert supporting the evaluation of short-term and long-term disability claims. In this role, you will analyze medical information, assess functional capacity, collaborate with healthcare providers,andprovideclinicalguidancethatsupportsclaimdecisions.Youwillplayacriticalroleinenhancingcustomeroutcomesthroughsoundclinicaljudgment,proactivecasecollaboration,andacommitmenttoexceptionalservice.

A highly motivated and clinically skilled registered nurse who thrives in a fast-paced, customer-focused environment. You can work independently while also collaborating effectively with claim professionals, healthcare providers, vocational specialists, and internal business partners. You are analytical, detail-oriented, and decisive, with the abilitytoevaluatecomplexmedicalinformationandtranslateclinicalfindingsintoactionablerecommendations.Youactwithurgencyandaccountabilitywhilemaintainingastrongcommitmenttoimprovingclaimantoutcomesandcustomerexperiences.

• ActiveRegisteredNurse(RN)license

• Minimumof5yearsofdirect acutepatientcareexperience

• Minimum of 3 years' experience as a clinical consultant in LTD and/or STD (LTD preferred)

• Strongknowledgeofmedicalconditions,treatments,andtheirimpactonfunctionalcapacityanddisabilityduration

• Excellentverbalandwrittencommunicationskills

• Strongclinicalassessment,analytical,criticalthinking,andresearchskills

• Abilitytoexerciseindependentjudgmentandmakesoundclinicaldecisions

• Strongorganizationalandtime-managementskillswiththeabilitytoprioritizecompetingdemands

• ProficiencywithMicrosoftOfficeapplications,includingWord,Excel,andPowerPoint

• Abilitytoadapttochangingbusinessneedsandworkeffectivelyinadynamicenvironment

• BachelorofScienceinNursing(BSN)

• CertifiedCaseManager(CCM)designation

• Experiencesupportingdisability,absencemanagement,orinsurance-basedclaimsoperations

• Knowledgeofdisabilityproducts,businessrules,andclaimsprocedures

• ExperiencewithDCMS,ClaimFacts,iProcess,orsimilarclaimsmanagementsystems

• Reviewshort-termandlong-termdisabilityclaimstoevaluatemedicaldocumentation,functionallimitations,treatmentprogress,andexpectedrecoverytimelines.

• Analyzetheimpactofillness,injury,andtreatmentplansonaclaimant’sabilitytoperformoccupationalanddailylivingactivities,providingclinicalrecommendationsthatsupportclaimdecisions.

• Collaboratewithtreatingproviders,claimants,casemanagers,andvocationalrehabilitationspecialiststopromoteappropriatetreatmentplans,clarifymedicalinformation,andfacilitatereturn-to-workopportunities.

• Serveasaclinicalsubjectmatterexpertbyeducatingclaimsprofessionalsonmedicalconditions,treatmentinterventions,functionalimpairments,anddisability-relatedoutcomes.

• Coordinateindependentmedicalreviewsandassessments,ensuringquality,accuracy,andtimelyresolutionofcomplexclinicalquestions.

• Manageahigh-volumeworkloadwhileprioritizingcustomerneeds,resolvingissuesproactively,andsupportingcontinuousqualityimprovementinitiatives.

• Provideongoingmentoringandtrainingtoclaimsstaffandpeersregardingthemedicalandfunctionalimpactofinjury,illness,andtreatmentondisabilityclaims.

• AsourRNClinicalConsultant,youwillreporttoourClinicalTeamLeader,whoreportstoourDirector,ClinicalServices.

• Plano, TX, Bethlehem, PA, Holmdel, NJ, or fully remote

• Occasional 0-10% of the time.

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

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.

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at . Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.

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. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. 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 . Please note: this resource is for accommodation requests only. For all other inquires related to your application and careers at Guardian, refer to the Guardian Careers site.

Guardian Life is not currently or in the foreseeable future sponsoring employment-based visas (e.g., such as an H-1B). In order to be a successful applicant, you must be legally authorized to work in the United States, without the need for employer sponsorship/support now or at any time in the future.

As part of Guardian’s job application process, Guardian may use artificial intelligence tools (“AI Tools") to automate the sorting and filtering of information provided by applicants as part of its preliminary screening. This preliminary screening may be used to help identify applicant materials and resumes relative to their indication that the applicant meets the requirements for the specific job for which they are applying, as specified in the listing posted on Guardian’s jobs website (Careers at Guardian at At Guardian, we do not use AI Tools to substantially assist or replace human judgment or discretionary decision making in our hiring process. All hiring decisions will be made by Guardian colleagues.

Please be aware that if you apply for a specific position with Guardian, you will have the choice of opting out of Guardian’s use of AI Tools during the job application process. If you would like to request an alternative process that does not utilize AI Tools or would like to request a reasonable accommodation, within ten business days of your position application, you must email your request to , making sure to provide your name and job requisition identification number. Guardian will retain your applicant materials and resume and all information therefrom in accordance with Guardian’s document retention policy, a copy of which you may request via .

Additionally, at applicable times, Guardian will make public the most recent bias audit results for such AI tools, which may be found here.

Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.

Originally posted on Himalayas