RN Clinical Consultant
WFA Digital Insight
As the demand for healthcare professionals continues to grow, with a 27% increase in remote healthcare jobs in 2025, the RN Clinical Consultant role at Guardian stands out. This position requires a unique blend of clinical expertise and analytical skills, with Excel proficiency being a key asset. With the shift towards remote work, candidates can expect a flexible and dynamic work environment. Before applying, it's essential to understand the importance of independent decision-making and collaboration in this role. With Guardian's commitment to customer satisfaction, this role is perfect for those who thrive in fast-paced environments and are passionate about delivering exceptional service.
Job Description
About the Role
The RN Clinical Consultant plays a vital role in assessing and investigating medical information related to disability claims. As a clinical expert, you will provide comprehensive medical reviews and analysis to determine claim liability. This role requires a deep understanding of medical conditions and their impact on functional capacity.The RN Clinical Consultant will work closely with Case Managers to identify restrictions and limitations that affect an individual's ability to work. This collaborative approach ensures that customers receive optimal treatment outcomes and exceptional service. With a focus on customer experience, you will act with urgency and ownership to resolve issues promptly.
As a remote opportunity, this role offers the flexibility to work from anywhere in the United States. With occasional travel required (0-10% of the time), you will have the opportunity to work with a dynamic team and make a meaningful impact on customers' lives.
What You Will Do
- Conduct comprehensive medical reviews and analysis of long-term and short-term disability claims
- Identify restrictions, limitations, and duration impacting functional capacity based on medical data
- Collaborate with treating providers to ensure optimal treatment outcomes and customer satisfaction
- Provide technical expertise on the medical aspect of disability claims
- Develop and implement strategies to promote return to work and improve functional outcomes
- Educate providers and claimants on the benefits of return to work and medical outcomes
- Conduct analysis of claimant's current treatment plan and collaborate with healthcare providers
- Proactively contact treating providers to discuss treatment plans and clarify goals
- Serve as a technical resource on the medical aspect of long-term and short-term disability claims
- Identify opportunities to educate claim staff and peers on medical aspects of disability
- Provide ongoing training and mentoring to claims staff and peers
What We Are Looking For
- Minimum 5 years of experience in direct patient care settings
- BSN and CCM certification preferred
- Excellent verbal and written communication skills
- Strong problem-solving, analytical, clinical, and information research skills
- Ability to exercise independent and sound judgment in decision-making
- Strong time management and organizational skills
- Demonstrated ability to multi-task and manage changing priorities
- Strong knowledge of medical conditions and their application to disability products
- Professional oral, written, and presentation skills
- Strong PC skills, including Microsoft Office applications (MS Word, Excel, PowerPoint)
Nice to Have
- Experience with DCMS, Claim Facts, and iProcess
- Knowledge of disability products, business rules, and procedures
- Certification in case management or a related field
- Experience working in a remote environment
Benefits and Perks
- Competitive salary and benefits package
- Flexible remote work arrangement
- Opportunities for professional growth and development
- Comprehensive health insurance and wellness programs
- Retirement savings plan and employee assistance program
- Paid time off and holidays
- Access to cutting-edge technology and tools
- Collaborative and dynamic work environment
How to Stand Out
- To stand out as a candidate, highlight your experience working with Excel and analytical tools to analyze medical data.
- Showcase your ability to work independently and collaboratively in a fast-paced environment.
- Prepare examples of how you've improved customer satisfaction and resolved complex issues in previous roles.
- Be ready to discuss your knowledge of medical conditions and their application to disability products.
- When negotiating salary, consider the value of the flexible remote work arrangement and comprehensive benefits package.
- Pay attention to the company culture and values, and be prepared to discuss how you align with them.
- Make sure to research the company's approach to customer experience and be prepared to discuss how you can contribute to it.
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