RN Clinical Consultant

Guardian; United States; Remote; USD 69,000 - 113,000; Full time

Job summary

Guardian Life is seeking an RN Clinical Consultant to support disability claim evaluations. You will review medical information, assess functional capacity, and provide clinical guidance to inform claim decisions.

The role requires independent judgment, strong communication, and collaboration with treating providers, claimants, and case managers. Based in the United States with remote options, you will manage a high-volume workload while maintaining quality and timely resolutions, contributing

Qualifications

• Active RN license required and current in good standing.
• Minimum 5 years direct acute patient care experience.
• Minimum 3 years as a clinical consultant in LTD/STD (LTD preferred).
• Strong knowledge of medical conditions and their impact on function.
• Excellent verbal and written communication skills.
• Analytical, critical thinking and research skills.
• Ability to exercise independent judgment and make clinical decisions.
• Strong organizational and time-management capabilities.
• Proficiency with Microsoft Office (Word/Excel/PowerPoint).
• Ability to adapt to changing business needs in a dynamic environment.

Responsibilities

• Review short- and long-term disability cases to evaluate medical documentation and functional limits.
• Analyze illness/injury/treatment impacts on daily living and work capabilities with clinical recommendations.
• Collaborate with treaters, claimants, case managers and vocational specialists to plan treatment and return-to-work.
• Serve as clinical SME educating claims staff on medical conditions and functional outcomes.
• Coordinate independent medical reviews and ensure timely resolution of complex questions.
• Manage high-volume workload while prioritizing customer needs and quality.
• Provide ongoing mentoring and training to claims staff on medical implications.

Skills

Excellent verbal and written comms

Analytical and critical thinking

Independent judgment

Organizational and time management

MS Office proficiency (Word, Excel, PP

Adaptability to changing needs

Knowledge of medical conditions and EF

Collaborative, team-oriented

Education

Active RN license

BSN preferred

CCM certification preferred

Tools

DCMS

ClaimFacts

iProcess

Job description

Location: United States

Areyouaregisterednursewhoispassionateabouthelpingindividualsachieveoptimalrecoveryandreturn-to-workoutcomes?GuardianisseekinganRNClinicalConsultant to serve as a clinical expert supporting the evaluation of short-term and long-term disability claims. In this role, you will analyze medical information, assess functional capacity, collaborate with healthcare providers,andprovideclinicalguidancethatsupportsclaimdecisions.Youwillplayacriticalroleinenhancingcustomeroutcomesthroughsoundclinicaljudgment,proactivecasecollaboration,andacommitmenttoexceptionalservice.

Youare

A highly motivated and clinically skilled registered nurse who thrives in a fast-paced, customer-focused environment. You can work independently while also collaborating effectively with claim professionals, healthcare providers, vocational specialists, and internal business partners. You are analytical, detail-oriented, and decisive, with the abilitytoevaluatecomplexmedicalinformationandtranslateclinicalfindingsintoactionablerecommendations.Youactwithurgencyandaccountabilitywhilemaintainingastrongcommitmenttoimprovingclaimantoutcomesandcustomerexperiences.

Youhave

RequiredQualifications:

• ActiveRegisteredNurse(RN)license

• Minimumof5yearsofdirect acutepatientcareexperience

• Minimum of 3 years' experience as a clinical consultant in LTD and/or STD (LTD preferred)

• Strongknowledgeofmedicalconditions,treatments,andtheirimpactonfunctionalcapacityanddisabilityduration

• Excellentverbalandwrittencommunicationskills

• Strongclinicalassessment,analytical,criticalthinking,andresearchskills

• Abilitytoexerciseindependentjudgmentandmakesoundclinicaldecisions

• Strongorganizationalandtime-managementskillswiththeabilitytoprioritizecompetingdemands

• ProficiencywithMicrosoftOfficeapplications,includingWord,Excel,andPowerPoint

• Abilitytoadapttochangingbusinessneedsandworkeffectivelyinadynamicenvironment

PreferredQualifications:

• BachelorofScienceinNursing(BSN)
• CertifiedCaseManager(CCM)designation

• Experiencesupportingdisability,absencemanagement,orinsurance-basedclaimsoperations

• Knowledgeofdisabilityproducts,businessrules,andclaimsprocedures

• ExperiencewithDCMS,ClaimFacts,iProcess,orsimilarclaimsmanagementsystems

Youwill

• Reviewshort-termandlong-termdisabilityclaimstoevaluatemedicaldocumentation,functionallimitations,treatmentprogress,andexpectedrecoverytimelines.

• Analyzetheimpactofillness,injury,andtreatmentplansonaclaimant’sabilitytoperformoccupationalanddailylivingactivities,providingclinicalrecommendationsthatsupportclaimdecisions.

• Collaboratewithtreatingproviders,claimants,casemanagers,andvocationalrehabilitationspecialiststopromoteappropriatetreatmentplans,clarifymedicalinformation,andfacilitatereturn-to-workopportunities.

• Serveasaclinicalsubjectmatterexpertbyeducatingclaimsprofessionalsonmedicalconditions,treatmentinterventions,functionalimpairments,anddisability-relatedoutcomes.

• Coordinateindependentmedicalreviewsandassessments,ensuringquality,accuracy,andtimelyresolutionofcomplexclinicalquestions.

• Manageahigh-volumeworkloadwhileprioritizingcustomerneeds,resolvingissuesproactively,andsupportingcontinuousqualityimprovementinitiatives.

• Provideongoingmentoringandtrainingtoclaimsstaffandpeersregardingthemedicalandfunctionalimpactofinjury,illness,andtreatmentondisabilityclaims.

ReportingRelationships

• AsourRNClinicalConsultant,youwillreporttoourClinicalTeamLeader,whoreportstoourDirector,ClinicalServices.

Location

• Plano, TX, Bethlehem, PA, Holmdel, NJ, or fully remote

Travel

• Occasional 0-10% of the time.

Salary Range:

$68,970.00 - $113,310.00

The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.

Our Promise

At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.

Inspire Well-Being

As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at . Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.

Equal Employment Opportunity

Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.

Accommodations

Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact . Please note: this resource is for accommodation requests only. For all other inquires related to your application and careers at Guardian, refer to the Guardian Careers site.

Visa Sponsorship

Guardian Life is not currently or in the foreseeable future sponsoring employment-based visas (e.g., such as an H-1B). In order to be a successful applicant, you must be legally authorized to work in the United States, without the need for employer sponsorship/support now or at any time in the future.

Notice Regarding Guardian’s Use of Artificial Intelligence in Recruitment

As part of Guardian’s job application process, Guardian may use artificial intelligence tools (“AI Tools") to automate the sorting and filtering of information provided by applicants as part of its preliminary screening. This preliminary screening may be used to help identify applicant materials and resumes relative to their indication that the applicant meets the requirements for the specific job for which they are applying, as specified in the listing posted on Guardian’s jobs website (Careers at Guardian at At Guardian, we do not use AI Tools to substantially assist or replace human judgment or discretionary decision making in our hiring process. All hiring decisions will be made by Guardian colleagues.

Please be aware that if you apply for a specific position with Guardian, you will have the choice of opting out of Guardian’s use of AI Tools during the job application process. If you would like to request an alternative process that does not utilize AI Tools or would like to request a reasonable accommodation, within ten business days of your position application, you must email your request to , making sure to provide your name and job requisition identification number. Guardian will retain your applicant materials and resume and all information therefrom in accordance with Guardian’s document retention policy, a copy of which you may request via .

Additionally, at applicable times, Guardian will make public the most recent bias audit results for such AI tools, which may be found here.