Remote RN Clinical Consultant for Disability & Return-to-Work

Guardian Life; Salt Lake City (UT); Remote; USD 69,000 - 113,000; Full time

Job summary

Guardian Life seeks an experienced RN Clinical Consultant to evaluate disability claims, analyze medical information, and provide clinical recommendations for claim decisions. You will collaborate with providers, claimants, and staff, ensuring timely, high-quality outcomes while maintaining strict confidentiality and accountability.

Responsibilities include coordinating reviews, mentoring staff, and returning claimants to work through evidence-based treatment plans.

Qualifications

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

Responsibilities

• Review short-term and long-term disability claims to evaluate medical documentation and functional limitations.
• Analyze impact of illness, injury, and treatment plans on a claimant's ability to perform daily living activities.
• Collaborate with treating providers, claimants, case managers, and vocational rehab specialists to promote appropriate treatment plans and return-to-work opportunities.
• Educate claims professionals on medical conditions and disability outcomes.
• Coordinate independent medical reviews and assessments for timely resolution of complex clinical questions.
• Manage high-volume workload while prioritizing customer needs and quality improvement initiatives.
• Provide ongoing mentoring and training to claims staff regarding medical and functional impacts on claims.

Skills

RN license

Acute care 5y

LTD/STD exp 3y

Medical conditions knowledge

Verbal & written comms

Clinical assessment

Independent judgment

Time management

MS Office

Education

BSN (preferred)

CCM designation (preferred)

Tools

DCMS

ClaimFacts

iProcess

Job description

Guardian Life seeks an experienced RN Clinical Consultant to evaluate disability claims, analyze medical information, and provide clinical recommendations for claim decisions. You will collaborate with providers, claimants, and staff, ensuring timely, high-quality outcomes while maintaining strict confidentiality and accountability.

Responsibilities include coordinating reviews, mentoring staff, and returning claimants to work through evidence-based treatment plans.