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

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

Consultant, Nurse Disability I

Key skills