RN Clinical Consultant

The Guardian Life Insurance Company of America; United States; Remote; USD 69,000 - 113,000; Full time

Job summary

The Guardian Life Insurance Company of America is seeking an RN Clinical Consultant to support disability claim evaluations, assess functional capacity, and provide clinical guidance for decision-making. This role involves collaboration with healthcare providers, claimants, and internal teams to optimize outcomes.

Candidates should be an active RN with acute care experience and a background in LTD/STD claims. Remote-friendly options and travel up to 10% are available in multiple U.S. locations.

Qualifications

• Active RN license required.

Responsibilities

• Review short-term and long-term disability claims to evaluate medical documentation and functional limitations.
• Collaborate with treating providers, claimants, case managers, and vocational specialists to promote appropriate treatment plans.
• Educate claims professionals on medical conditions, treatments, and disability-related outcomes.

Skills

RN license

Acute care experience

Clinical consultant experience

Medical knowledge

Communication skills

Analytical thinking

Independent judgment

Time management

MS Office

Adaptability

Education

BSN

CCM designation

Tools

DCMS

Claim Facts

iProcess

Job description

Job Overview

Are you a registered nurse who is passionate about helping individuals achieve optimal recovery and return-to-work outcomes? Guardian is seeking an RN Clinical Consultant 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, and provide clinical guidance that supports claim decisions. You will play a critical role in enhancing customer outcomes through sound clinical judgment, proactive case collaboration, and a commitment to exceptional service. You are 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 ability to evaluate complex medical information and translate clinical findings into actionable recommendations. You act with urgency and accountability while maintaining a strong commitment to improving claimant outcomes and customer experiences.

Required Qualifications

• Active Registered Nurse (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 and work effectively in a dynamic environment

Preferred Qualifications

• Bachelor of Science in Nursing (BSN)
• Certified Case Manager (CCM) designation
• Experience supporting disability, absence management, or insurance-based claims operations
• Knowledge of disability products, business rules, and claims procedures
• Experience with DCMS, Claim Facts, iProcess, or similar claims management systems

You will 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.

Reporting Relationships

As our RN Clinical Consultant, you will report to our Clinical Team Leader, who reports to our Director, Clinical Services.

Location

Plano, TX, Bethlehem, PA, Holmdel, NJ, or fully remote. Travel Occasional 0-10% of the time.

Salary Range

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 www.guardianlife.com/careers/corporate/benefits. Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits. Every day, Guardian helps our 29 million customers realize their dreams through a range of insurance and financial products and services. Our Purpose, to inspire well-being, guides our dedication to the colleagues, consumers, and communities we serve. We know that people count, and we go above and beyond to prepare them for the life they want to live, focusing on their overall well-being — mind, body, and wallet. As one of the largest mutual insurance companies, we put our customers first. Behind every bright future is a GuardianTM. Learn more about Guardian at guardianlife.com.

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 [e-mail]. 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.