Clinical Nurse Consultant
4 weeks ago
We are seeking a highly motivated Clinical Nurse Consultant to join our team. As a key member of our clinical organization, you will be responsible for reviewing and analyzing medical information to support disability claims.
In this role, you will act as a clinical resource for Group Protection benefit specialists and claim professionals, evaluating medical information to clarify diagnoses, evaluating the severity of medical conditions, validating medical restrictions and limitations, and estimating duration of recovery.
You will also provide coaching and guidance to claims regarding medical management, clarify, interpret and/or evaluate medical information to assess appropriateness of current and ongoing restrictions / limitations and level of impairment, and identify pertinent clinical facts and answers questions in collaboration with benefits specialists and physician consultants.
Key Responsibilities:
- Evaluate medical information to clarify diagnoses, evaluating the severity of medical conditions, validating medical restrictions and limitations, and estimating duration of recovery
- Clarify, interpret and/or evaluate medical information to assess appropriateness of current and ongoing restrictions / limitations and level of impairment
- Identify pertinent clinical facts and answers questions in collaboration with benefits specialists and physician consultants
- Act as a clinical resource to Group Protection claim professionals during claim meetings and as needed
- Recommend specific medical information needed to evaluate ongoing level of impairment and to facilitate optimal claim management
- Make appropriate referrals to internal and external clinical resources (i.e. IME, FCE, Peer Reviews)
- Discuss complex medical issues with health care providers as needed and documents outcomes of discussion
- Coordinate and partner with Vocational Rehabilitation Coordinators (VRC) and others to support with return-to-work services
- Effectively manages assigned caseload within department productivity goals
- Contacts claimants, employers, and health care providers, as indicated
Requirements:
- 4 Year/Bachelor's Degree in Nursing
- Registered Nurse License - Current, unrestricted license in the state where the position is located
- Minimum of 3-5 years of nursing experience with preferred clinical nursing expertise in Emergency Room, Critical Care, Orthopedics, Coronary Care, or trauma
- Previous insurance industry experience preferred
- Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred
About Us:
Lincoln Financial Group is a leading provider of financial services, helping people plan, protect and retire with confidence. We are committed to creating a diverse and inclusive environment and are proud to be an equal opportunity employer.
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