Clinical Consultant

Sun Life Financial; Portland (ME); Hybrid; USD 77,000 - 116,000; Full time

Benefits offered by this job

Vacation & sick time

Family leave

Medical coverage

Life & AD&D insurance

Disability programs

Sabbatical program

401(k) match

Stock purchase plan

Employer-funded retirement

Job summary

Sun Life U.S. is seeking a Clinical Consultant to join the Clinical Services team in a hybrid role.

You will apply clinical expertise within an interdisciplinary group that focuses on returning clients to productive work, using electronic medical records and phone/fax communication rather than direct care. You will evaluate complex medical conditions, provide treatment insights, and partner with claims professionals to inform decisions.

Qualifications

• RN licensure active and unrestricted.
• BSN preferred.
• CCM/CRRN certification or eligible with 3+ years clinical experience with adult population.
• Experience in rehabilitation, Occupational Health, Case/Care Management, Disability Insurance, or Workers' compensation a plus.
• Strong communication across multiple audiences.
• Proficiency with MS Office and clinical systems.
• Self-motivated with excellent critical thinking, time management, and judgment skills.

Responsibilities

• Evaluate medical documentation to assess disability claims and functional capabilities.
• Provide clinical insight on complex medical conditions, treatment plans, and recovery timelines.
• Collaborate with claims professionals to synthesize facts and support quality decisions.
• Educate and consult with physicians, vocational counselors, employers, and other stakeholders.
• Communicate medical determinations via phone and written reports.
• Support return-to-work (RTW) planning through evaluation of restrictions, accommodations, and functional potential.
• Participate in peer collaboration and claims roundtables to share best practices.
• Mentor peers and educate internal teams on clinical topics and trends.

Skills

Communication skills

MS Office proficiency

Critical thinking

Time management

Education

RN licensure (active, unrestricted)

BSN preferred

CCM or CRRN certification or eligible

Tools

Microsoft Outlook

Microsoft Word

Microsoft Excel

Clinical systems

Job description

Job Description

Sun Life U.S. is one of the largest providers of employee and government benefits, helping approximately 50 million Americans access the care and coverage they need. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation. We have more than 6,400 employees and associates in our partner dental practices and operate nationwide. At Sun Life, we're driven by our Purpose: helping our Clients achieve lifetime financial security and live healthier lives. Our values shape how we work: caring, authentic, bold, inspiring, and impactful. When you join Sun Life, you'll work with passionate colleagues and empowering leaders who support your growth and celebrate your contributions, so you can make a meaningful difference in our Clients' lives. Visit our website to discover how Sun Life is making life brighter for our customers, partners and communities.

Job Description: Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week. The opportunity: Sun Life operates with a Work Is Healthy (WisH) approach for disability claims management. As a Clinical Consultant within our Clinical Services team, you will apply your clinical expertise as a member of an interdisciplinary team that focuses on returning clients to optimal levels of productivity. This role does not involve hands‑on assessment or direct care. All work is solely performed using electronic medical records and phone/fax communication.

How you will contribute

• Evaluate medical documentation to assess disability claims and functional capabilities.
• Provide clinical insight on complex medical conditions, treatment plans, and recovery timelines.
• Collaborate with claims professionals to synthesize facts and support quality decisions.
• Educate and consult with physicians, vocational counselors, employers, and other stakeholders.
• Communicate medical determinations via phone and written reports.
• Support return‑to‑work (RTW) planning through evaluation of restrictions, accommodations, and functional potential.
• Participate in peer collaboration and claims roundtables to share best practices.
• Mentor peers and educate internal teams on clinical topics and trends.

What you will bring with you

• Ability to work with a diverse range of people
• RN licensure, active and unrestricted,
• BSN preferred
• Specialty certification such as CCM, CRRN, or eligible with desire to pursue a plus 3+ years of clinical experience working with an adult working age population
• Experience in a rehabilitation setting, Occupational Health, Case/Care Management, Disability Insurance, Group Benefits, or Workers compensation a plus
• Strong communication skills to consult professionally across multiple audiences.
• Proficiency in Microsoft Office tools, including Outlook, Word, Excel, and clinical systems.
• Self‑motivated with excellent critical thinking, time management, and judgment skills.

Salary

Salary: $77,400 - $116,100. At our company, we are committed to pay transparency and equity. The salary range for this role is competitive nationwide, and we strive to ensure that compensation is fair and equitable. Your actual base salary will be determined based on your unique skills, qualifications, experience, education, and geographic location. In addition to your base salary, this position is eligible for a discretionary annual incentive award based on your individual performance as well as the overall performance of the business. We are dedicated to creating a work environment where everyone is rewarded for their contributions.

Benefits

• generous vacation and sick time
• market-leading paid family, parental and adoption leave
• medical coverage
• company paid life and AD&D insurance
• disability programs
• a partially paid sabbatical program
• 401(k) employer match
• stock purchase options
• an employer-funded retirement account

We are committed to fostering an inclusive environment where all employees feel they belong, are supported and empowered to thrive.

We are dedicated to building teams with varied experiences, backgrounds, perspectives and ideas that benefit our colleagues, clients, and the communities where we operate.

We encourage applications from qualified individuals from all backgrounds.

We will make reasonable accommodations to the known physical or mental limitations of otherwise-qualified individuals with disabilities or special disabled veterans, unless the accommodation would impose an undue hardship on the operation of our business.

Please email [e-mail] to request an accommodation.

For applicants residing in California, please read our employee California Privacy Policy and Notice.

We do not require or administer lie detector tests as a condition of employment or continued employment.

Sun Life will consider for employment all qualified applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including applicable fair chance ordinances.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Category: Claims – Clinical Posting End Date: 30/10/2026

We’re proud to be recognized in our communities as a top employer.

Proudly Great Place to Work Certified in Canada and the U.S., we’ve also been recognized as a "Top 10" employer by the Boston Globe's "Top Places to Work" for two years in a row.

Visit our website to learn more about our benefits and recognition within our communities.

Shine together At Sun Life, you can be your most brilliant self. Our supportive, flexible, and inclusive work environment is one where you – and your career – can thrive. Whatever your aspirations, collaborative leaders and colleagues are ready to help you learn, grow, and succeed. Make life brighter We’re a global company with a passion for people. Our purpose is to help Clients achieve lifetime financial security and live healthier lives. As a team of 30,000 across 26 countries, our impact is far-reaching, and locally relevant There’s power in numbers. As part of Sun Life’s growing team, you have an impact on people in your community and around the world. Shape the future With an optimistic eye on a brighter future, we drive to innovate. Be part of leading change, push boundaries and try new ways of working. Use data to drive bold actions. Be agile and pivot as we test and learn. At Sun Life, we’re driving transformation, sustainability and innovation for our Clients, employees, partners, and communities. Join us. Together, we can make the future brighter. Join a top employer for a brighter future. Visit Sun Life Careers.