Remote RN Clinical Consultant - Disability Claims

Guardian Life; Honolulu (HI); Remote; USD 69,000 - 113,000; Full time

Job summary

Guardian Life seeks an RN Clinical Consultant to act as a clinical expert supporting disability claim evaluations. You will analyze medical information, assess functional capacity, and collaborate with providers to guide claim decisions.

This role emphasizes proactive case collaboration, clinical judgment, and exceptional service for claimants. The position requires licensure as an active RN and substantial direct patient care experience, with preferred BSN and CCM credentials.

Qualifications

• Active RN license is required.
• Minimum 5 years of direct acute patient care experience.
• Minimum 3 years as a clinical consultant in LTD/STD.
• Strong knowledge of medical conditions and impact on functional capacity.
• Excellent verbal and written communication skills.

Responsibilities

• Review short- and long-term disability claims to evaluate medical documentation and functional limitations.
• Analyze illness, injury, and treatment plans and their impact on daily living activities.
• Collaborate with treating providers, claimants, and vocational specialists to support appropriate treatment and return-to-work options.
• Serve as a clinical subject-matter expert educating claims professionals on medical conditions and outcomes.
• Coordinate independent medical reviews ensuring quality and timely resolution of complex questions.
• Manage high-volume workload with a focus on customer needs and quality improvement.

Skills

Active RN license

5+ years acute patient care

3+ years LTD/STD clinical consultant

Medical knowledge of conditions and AD

Verbal and written communication

Clinical assessment and analytical

Independent judgment

Time management

MS Office proficiency

Adaptability

Education

BSN

Certified Case Manager (CCM)

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Guardian Life seeks an RN Clinical Consultant to act as a clinical expert supporting disability claim evaluations. You will analyze medical information, assess functional capacity, and collaborate with providers to guide claim decisions.

This role emphasizes proactive case collaboration, clinical judgment, and exceptional service for claimants. The position requires licensure as an active RN and substantial direct patient care experience, with preferred BSN and CCM credentials.