Clinical Consultant - Benefit Operations
About The Position
The Clinical Consultant reviews, analyzes, and interprets medical information. Working collaboratively 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 working 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 providing an exceptional, positive experience in every interaction. The position applies medical knowledge to claim-file assessment and synthesis, communicates complex medical issues clearly, and collaborates with internal and external resources to guide file direction. It also provides coaching to non-medical staff, maintains professional certifications, and completes ongoing educational activities to stay current with medical trends.
Requirements
- Associate Degree in Nursing and an active RN License.
- Ability to work in a fast-paced, team environment.
Nice To Haves
- Bachelor's degree strongly preferred.
- Three or more years of clinical experience preferred.
Responsibilities
- Assess and synthesize claim-file information using medical knowledge, and offer balanced conclusions.
- Communicate complex medical issues concisely in writing and verbally in a fast-paced, multidisciplinary team environment.
- Collaborate with internal resources to identify pertinent medical documentation needed to assess file direction accurately.
- Collaborate with external resources and healthcare providers to build partnerships, discuss treatment plans, clarify functional capacity, and assess file direction.
- Coach non-medical staff to increase their medical knowledge.
- Meet quality and quantity performance standards while adapting with urgency and flexibility to a rapidly changing environment.
- Maintain professional certifications, stay abreast of new medical trends, and complete required educational activities.
Benefits
- Health, vision, and dental coverage.
- Short- and long-term disability coverage.
- Performance-based incentive plans.
- Paid time off, including paid time to volunteer.
- 401(k) employer contributions: up to 9.5% as described in the posting.
- Mental health support.
- Career advancement opportunities.
- Student loan repayment options.
- Tuition reimbursement.
- Flexible work environments.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
