Clinician

Prudential Ins Co of America; Fort Washington (MD); Remote; USD 82,000 - 135,000; Full time

Benefits offered by this job

Market-competitive base salaries

Medical, dental, vision, life, and STD

401(k) with company match

Pension plan

Wellness programs

Work/Life resources

Education benefit

Employee Stock Purchase Plan

Job summary

Prudential Ins Co of America is seeking an experienced professional to review medical documentation and determine medically supported restrictions for Long-Term Disability claims. You will collaborate with clinicians, claims teams, and vocational resources to determine the best course for claim management.

The role supports the Expert Resource Team with remote work, potential on-site presence as needed, and exposure to a leading financial services insurer.

Qualifications

• RN/PT/OT license must be current.
• 3+ years of acute care experience.
• Experience in case management.
• Strong interpersonal and written/verbal communication skills; ability to interface with multiple disciplines.
• Proficient in MS Office; Excel experience required.
• Ability to work independently and in a team.

Responsibilities

• Review and assess complex illness and injury claims.
• Identify restrictions and limitations to assist claim handling.
• Support strategy and utilization of additional resources with strong analytical thinking.
• Document clinical assessments with clear written/verbal communication; contact providers and other stakeholders.
• Demonstrate ability to work independently with minimal supervision.

Skills

Interpersonal skills

Communication skills

Team collaboration

Tools

MS Office / Excel

Job description

Job Classification: Operations - Insurance Operations

At Prudential, we believe talent is key to achieving our vision. When you join Prudential, you'll unlock a motivating and impactful career - all while growing your skills and advancing your profession at one of the world's leading financial services institutions!

Are you a problem solver who can use critical thinking skills? Are you self-motivated teammate with strong organizational skills? Then this opportunity may be what you are looking for!

You will be a member of the Expert Resource Team supporting Long-Term Disability Claims Teams which is part of our Group Insurance Business. We have Long-Term Disability offices in and Newark NJ, Portland ME, and Scottsdale AZ, with many of our staff members working virtually.

The current employee work arrangement for this position is fully virtual. While this position does not require your on-site presence on a regular basis, depending on business preferences, there may be occasions where you are required to be on-site at a Prudential office.

What you can expect:

In this role, you will be reviewing medical documentation in case files to make determinations on medically supported restrictions and limitations for clients. Our clinicians work in collaboration with our claims teams, our physicians, our return to work coordinators and vocational departments to resolve the best course for claim management.

Here are some of the responsibilities for the role:

• Review and assessment of primarily complex illness and injury claims
• Identify restrictions and limitations based on physiological, psychological, and social factors to assist claim management staff in their claim handling activities.
• Assist in strategy as well as identifying appropriate utilization of additional clinical, vocational, or other resources which will require excellent analytical and critical thinking skills
• Apply effective written and verbal communication skills to document clinical assessments; contact Treating Providers; engage in discussions with other resources including but not limited to Disability Claim Team Members, Clinical Peers and Vocational Rehabilitation Counselor Resources
• Exhibit ability to work independently with minimal direct supervision

What you'll need:

• RN/PT/OT license - must be current.
• 3+ years of acute care experience
• Experience in case management
• Strong interpersonal and communication skills (written and verbal), a high level of organizational effectiveness, and the ability to interface with multiple disciplines.
• Computer proficiency and technical aptitude with the ability to utilize MS office including Excel Spreadsheets
• Ability to work both independently and within a team environment.

It'd be a plus if you had:

• Prior insurance industry experience

• Experience with Long-Term Disability (LTD) products

#LI-Remote

What we offer you:

Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $82,000.00 to $135,300.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills.

• Market competitive base salaries, with a yearly bonus potential at every level.
• Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of absences, such as parental and military leave.
• 401(k) plan with company match (up to 4%).
• Company-funded pension plan.
• Wellness Programs including up to $1,600 a year for reimbursement of items purchased to support personal wellbeing needs.
• Work/Life Resources to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development.
• Education Benefit to help finance traditional college enrollment toward obtaining an approved degree and many accredited certificate programs.
• Employee Stock Purchase Plan: Shares can be purchased at 85% of the lower of two prices (Beginning or End of the purchase period).

Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance. To find out more about our Total Rewards package, visit Work Life Balance | Prudential Careers. Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.

Prudential Financial, Inc. of the United States is not affiliated with Prudential plc. which is headquartered in the United Kingdom.

Prudential is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, national origin, ancestry, sex, sexual orientation, gender identity, national origin, genetics, disability, marital status, age, veteran status, domestic partner status, medical condition or any other characteristic protected by law.

To maintain the integrity and security of our hiring process, Prudential may use identity verification technologies. Your consent will be obtained before any verification takes place.

If you need an accommodation to complete the application process, please email [e-mail] .

If you are experiencing a technical issue with your application or an assessment, please email [e-mail] to request assistance.