Clinical Consultant - Absence Operations

Unum Group•Chattanooga, TN

About The Position

The Clinical Consultant reviews, analyzes, and interprets medical information. Working with claims professionals, on-site physicians, and other resources across multiple settings, the consultant assesses medical information and determines appropriate next steps. The role includes collaborating with healthcare providers to clarify functional capacity, recovery expectations, and treatment plans, and initiating return-to-work plans where appropriate. The consultant is accountable for delivering exceptional service in every interaction and creating a positive experience. The position applies medical knowledge to assess and synthesize claim-file information and reach balanced conclusions. It involves communicating complex medical issues clearly in writing and verbally in a fast-paced, multidisciplinary environment; identifying needed medical documentation with internal partners; and partnering with external resources to discuss treatment plans, clarify functional capacity, and assess claim direction. The consultant also coaches non-medical staff, meets quality and quantity performance standards, adapts to a rapidly changing environment, and maintains professional certifications and required education while keeping abreast of medical trends.

Requirements

Associate degree in Nursing.
Active Registered Nurse (RN) license.
Ability to work in a fast-paced, team environment.
Maintain required professional certifications and complete required educational activities.

Nice To Haves

Bachelor of Science degree is strongly preferred.
Three or more years of clinical experience is preferred.
Capacity and interest in developing broad business and leadership skills.
Openness to diverse ideas and experiences, with self-awareness about strengths and development areas.

Responsibilities

Review, analyze, and interpret medical information and claim-file documentation.
Assess and synthesize claim information to reach balanced conclusions and determine appropriate next steps.
Collaborate with claims professionals, on-site physicians, and other internal resources to identify relevant medical documentation and assess claim direction.
Work with healthcare providers and other external resources to discuss treatment plans, clarify functional capacity and recovery expectations, and initiate return-to-work plans where appropriate.
Communicate complex medical issues concisely, both verbally and in writing, in a multidisciplinary team environment.
Coach non-medical staff to increase their medical knowledge.
Meet quality and quantity performance standards while responding flexibly and urgently to changing needs.
Maintain professional certifications, stay abreast of medical trends, and complete required educational activities.