Remote RN Clinical Consultant - Disability Claims

Guardian Life; Boise (ID); Remote; USD 69,000 - 113,000; Full time

Job summary

Guardian Life is seeking an RN Clinical Consultant to support short-term and long-term disability claims with expert clinical judgment. You will analyze medical information, assess functional capacity, and collaborate with providers and claim professionals to guide decisions.

The role requires an active RN license, 5+ years acute care, 3+ years as a clinical consultant in LTD/STD, and strong communication and analytical skills. Remote work options in the US are available.

Qualifications

• Active RN license.
• Minimum of 5 years of direct acute patient care experience.
• Minimum of 3 years' experience as a clinical consultant in LTD and/or STD (LTD preferred).
• Strong knowledge of medical conditions, treatments, and their impact on functional capacity and disability duration.
• Excellent verbal and written communication skills.
• Strong clinical assessment, analytical, critical-thinking, and research skills.
• Ability to exercise independent judgment and make sound clinical decisions.
• Strong organizational and time-management skills with the ability to prioritize competing demands.
• Proficiency with Microsoft Office applications, including Word, Excel, and PowerPoint.
• Ability to adapt to changing business needs in a dynamic environment.

Responsibilities

• Review short-term and long-term disability claims to evaluate medical documentation, functional limitations, treatment progress, and expected recovery timelines.
• Analyze the impact of illness, injury, and treatment plans on a claimant’s ability to perform occupational and daily living activities, providing clinical recommendations that support claim decisions.
• Collaborate with treating providers, claimants, case managers, and vocational rehabilitation specialists to promote appropriate treatment plans, clarify medical information, and facilitate return-to-work opportunities.
• Serve as a clinical subject matter expert by educating claims professionals on medical conditions, treatment interventions, functional impairments, and disability-related outcomes.
• Coordinate independent medical reviews and assessments, ensuring quality, accuracy, and timely resolution of complex clinical questions.
• Manage a high-volume workload while prioritizing customer needs, resolving issues proactively, and supporting continuous quality improvement initiatives.
• Provide ongoing mentoring and training to claims staff and peers regarding the medical and functional impact of injury, illness, and treatment on disability claims.

Skills

RN license

Clinical consulting

Medical review

Independent judgment

Time management

Microsoft Office

Education

Bachelor of Science in Nursing (BSN)

CCM designation

Tools

DCMS

ClaimFacts

iProcess

Word

Excel

PowerPoint

Job description

Guardian Life is seeking an RN Clinical Consultant to support short-term and long-term disability claims with expert clinical judgment. You will analyze medical information, assess functional capacity, and collaborate with providers and claim professionals to guide decisions.

The role requires an active RN license, 5+ years acute care, 3+ years as a clinical consultant in LTD/STD, and strong communication and analytical skills. Remote work options in the US are available.