Clinical Consultant, Disability Claims & Return-to-Work

Sunlife; United States; On-site; USD 77,000 - 116,000; Full time

Job summary

Sun Life U.S. is seeking a Clinical Consultant within Clinical Services to apply clinical expertise as part of an interdisciplinary team focusing on returning clients to productive levels of work. The role uses electronic medical records and phone/fax communication, with no hands-on care.

You will evaluate medical documentation, provide insights on complex conditions, educate physicians and stakeholders, and support return-to-work planning through evaluation of restrictions and accommodations.

Qualifications

• RN licensure active and unrestricted.
• BSN preferred.
• CCM or CRRN certification or eligible with intent to pursue.
• 3+ years of clinical experience with an adult working age population.
• Experience in rehabilitation, Occupational Health, Case/Care Management, Disability Insurance, Group Benefits, or Workers compensation a plus.
• Strong communication skills to consult across multiple audiences.
• Proficiency in Microsoft Office and clinical systems.
• Self-motivated with strong critical thinking, time management, and judgment.

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 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

RN licensure

CCM/CRRN

3+ years clinical experience

Rehabilitation/Occupational Health

Strong communication

Education

RN licensure with BSN preferred

Tools

Microsoft Office

Clinical systems

Job description

Sun Life U.S. is seeking a Clinical Consultant within Clinical Services to apply clinical expertise as part of an interdisciplinary team focusing on returning clients to productive levels of work. The role uses electronic medical records and phone/fax communication, with no hands-on care.

You will evaluate medical documentation, provide insights on complex conditions, educate physicians and stakeholders, and support return-to-work planning through evaluation of restrictions and accommodations.