Sr Clinical Consultant
About The Position
The Sr Clinical Case Manager is responsible for reviewing, analyzing, and interpreting complex medical information to support disability claims. This role collaborates closely with claims professionals, healthcare providers, and internal partners to assess functional capacity, clarify treatment plans, and support recovery and return-to-work strategies. Apply clinical expertise to assess and analyze claim file information, delivering objective, evidence-based recommendations. Communicate complex medical issues clearly and concisely, both verbally and in writing, within a fast-paced, multidisciplinary team environment. Collaborate with internal partners to identify and obtain pertinent medical documentation necessary for accurate functional assessments. Partner with healthcare providers and claimants to clarify diagnoses, treatment plans, anticipated outcomes, and return-to-work expectations. Provide coaching and consultation to non-clinical staff to enhance medical understanding and support appropriate claim management. Operate with a sense of urgency and adaptability to meet evolving business needs. Demonstrate strong time management by effectively prioritizing tasks, completing reviews promptly, and ensuring timely follow-up on all case activities. Maintain required professional certifications, stay current with medical trends, and complete ongoing educational requirements.
Requirements
- Associate Degree in Nursing and active RN license required
- 3+ years of clinical experience preferred
- Previous Disability medical case management experience preferred
- Excellent interpersonal, communication, and organizational skills
- Strong analytical and critical thinking abilities
- Proficiency with digital tools and comfort navigating multiple platforms
Nice To Haves
- Bachelor's degree strongly preferred
Responsibilities
- Reviewing, analyzing, and interpreting complex medical information to support disability claims.
- Collaborating closely with claims professionals, healthcare providers, and internal partners to assess functional capacity, clarify treatment plans, and support recovery and return-to-work strategies.
- Applying clinical expertise to assess and analyze claim file information, delivering objective, evidence-based recommendations.
- Communicating complex medical issues clearly and concisely, both verbally and in writing, within a fast-paced, multidisciplinary team environment.
- Collaborating with internal partners to identify and obtain pertinent medical documentation necessary for accurate functional assessments.
- Partnering with healthcare providers and claimants to clarify diagnoses, treatment plans, anticipated outcomes, and return-to-work expectations.
- Providing coaching and consultation to non-clinical staff to enhance medical understanding and support appropriate claim management.
- Operating with a sense of urgency and adaptability to meet evolving business needs.
- Demonstrating strong time management by effectively prioritizing tasks, completing reviews promptly, and ensuring timely follow-up on all case activities.
- Maintaining required professional certifications, staying current with medical trends, and completing ongoing educational requirements.
Benefits
- Health, dental, vision and life insurance plans
- 401(k) Savings plan – with generous company matching contributions (up to 6%)
- Voya Retirement Plan – employer paid cash balance retirement plan (4%)
- Tuition reimbursement up to $5,250/year
- Paid time off – including 20 days paid time off, nine paid company holidays and a flexible Diversity Celebration Day.
- Paid volunteer time — 40 hours per calendar year
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
Associate degree
