Clinical Consultant

Sun Life•Portland, ME

4d•Hybrid

About The Position

Sun Life embraces a hybrid work model that balances in-office collaboration with the flexibility of virtual work. Our team members and leaders are expected to foster connection and teamwork by being present in the office at least 2 days per week. The opportunity: Sun Life operates with a Work Is Healthy (WisH) approach for disability claims management. As a Clinical Consultant within our Clinical Services team, you will apply your clinical expertise as a member of an interdisciplinary team that focuses on returning clients to optimal levels of productivity. This role does not involve hands-on assessment or direct care. All work is solely performed using electronic medical records and phone/fax communication.

Requirements

Ability to work with a diverse range of people
RN licensure, active and unrestricted, BSN preferred
3+ years of clinical experience working with an adult working age population
Strong communication skills to consult professionally across multiple audiences.
Proficiency in Microsoft Office tools, including Outlook, Word, Excel, and clinical systems.
Self-motivated with excellent critical thinking, time management, and judgment skills.

Nice To Haves

Specialty certification such as CCM, CRRN, or eligible with desire to pursue a plus
Experience in a rehabilitation setting, Occupational Health, Case/Care Management, Disability Insurance, Group Benefits, or Workers compensation a plus

Responsibilities

Evaluate medical documentation to assess disability claims and functional capabilities.
Provide clinical insight on complex medical conditions, treatment plans, and recovery timelines.
Collaborate with claims professionals to synthesize facts and support quality decisions.
Educate and consult with physicians, vocational counselors, employers, and other stakeholders.
Communicate medical determinations via phone and written reports.
Support return-to-work (RTW) planning through evaluation of restrictions, accommodations, and functional potential.
Participate in peer collaboration and claims roundtables to share best practices.
Mentor peers and educate internal teams on clinical topics and trends.