Clinical Care Consultant (Registered Nurse)

OneAmerica Financial • South Portland, ME

6d • $79,500 - $132,500 • Hybrid

About The Position

The Clinical Care Consultant is responsible for supporting OneAmerica’s Claims operation acting both in a consultative nature during claim discussions and to provide comprehensive reviews of medical information. They are responsible for discussing and documenting an assessment of a claimant's potential for recovery and work function. Clinical Care Consultants also work closely with claims associates to educate regarding medical conditions, treatment, & recovery to function.

Requirements

• Current & active Registered Nurse (RN) license in their state of residency required.
• Clinical experience in acute care setting.
• Ability to influence and teach others. Use facilitation skills in a variety of discussions.
• Work in a self-directed way being able to make independent judgments and decisions.
• Prioritize and organize work independently while keeping the team and broader organizational needs in mind.
• Strong research, analytical, critical thinking, problem solving skills and decision-making skills
• Thrives in a fast-paced, service-oriented work environment with the need to pivot priorities according to needs of the business.
• Computer skills with strong proficiency in Microsoft programs especially Word, Excel, Outlook email and Teams web-conferencing and messaging.

Nice To Haves

• BSN preferred.
• 2-5 years' clinical experience within claims organization preferred

Responsibilities

• Conduct comprehensive clinical assessments of Short- and Long-Term Disability claims and Life Waiver of Premium.
• Participate in multidisciplinary meetings as the clinical resource. Provide answers regarding medical issues, and functionality. Provide clear and complete clinical short and long-term clinical recommendations.
• Assist claims associates with preparing information needed for peer reviews, IMEs, or FCEs by providing guidance around the specialty of provider to utilize and questions to ask of that provider.
• Collaborate with internal resources to assist the claims team in developing a sound action plan for a claim.
• Document claim files and systems in a clear and professional manner.
• Communicate effectively and professionally with a wide variety of peers and resources.

Benefits

• Medical & prescription, dental, vision insurance
• Health Savings Account & Flexible Spending Accounts
• Paid Time Off
• 10 weeks 100% paid parental leave (after completing 12 months of employment)
• 401(k) Plan with company match
• Pension Plan
• Company paid life & disability insurance
• Wellness Program & Company paid employee assistance program
• Clinic access subject to location (Indianapolis, Charlotte, Cincinnati)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level