Geriatric Claims Clinician

Genworth Financial, Inc.; United States; Hybrid; USD 69,000 - 103,000; Full time

Benefits offered by this job

Healthcare Coverage

401(k) Savings Plan

Paid Time Off

Employer Retirement Match

Disability & Life Insurance

Tuition Reimbursement

Wellness & EAP Support

Caregiver Support

Job summary

Genworth Financial, Inc. is seeking a Claims Clinical Specialist in Virginia with RN or LSW credentials. You will deliver evidence-based short-term case management to long-term care policyholders, perform telephonic assessments, and update care plans while coordinating with long-term care facilities and home care agencies.

This role emphasizes quality, risk management, and regulatory compliance. You will work in a hybrid in-office/remote setup with opportunities to impact certification processes

Qualifications

• Active Licensed Social Worker or Registered Nurse.
• At least two years’ experience handling complex aging health conditions and prognosis.
• Ability to interpret MDS, Plan of Care, physician records and disease progression.
• Experience applying risk management and quality protocols.
• Strong time management and prioritization in a production setting.
• Reliable attendance to support business needs.

Responsibilities

• Identify process improvements and provide feedback to enhance case management models.
• Communicate with medical personnel to conduct telephonic assessments and develop care plans.
• Assess medical status and care needs of insured clients to understand disease progression.
• Decide on care expectations and benefit eligibility per policy and HIPAA rules.
• Request and analyze medical records to inform disease progression and recovery potential.
• Operate in a productivity-driven environment using multiple computer systems.
• Manage phone queues to ensure timely customer service.
• Collaborate with other teams to support continuous improvement.

Skills

Licensed Social Worker

Registered Nurse

MDS interpretation

Care plan assessment

Clinical risk management

Multitasking

Decision making

Tools

Microsoft Word

Excel

PowerPoint

Job description

Genworth Financial, Inc. is seeking a Claims Clinical Specialist in Virginia with RN or LSW credentials. You will deliver evidence-based short-term case management to long-term care policyholders, perform telephonic assessments, and update care plans while coordinating with long-term care facilities and home care agencies.

This role emphasizes quality, risk management, and regulatory compliance. You will work in a hybrid in-office/remote setup with opportunities to impact certification processes