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About the Company
Company provides advice and solutions that help empower Americans to take charge of their financial lives with confidence and optimism. Today, more than 17 million customers trust our retirement, insurance and wealth protection expertise to help address their lifestyle, savings and income goals, as well as to guard against long-term care expenses. Headquartered in Radnor, Pennsylvania, Company is the marketing name for Company (NYSE:Company) and its affiliates. The company had $222 billion in assets under management as of March 31, 2015.
As a Nurse Disability Consultant, you will be responsible for reviewing, analyzing and interpreting medical information available in Group Protection claims. You will be evaluating medical information to clarify diagnoses, evaluating the severity of medical conditions, validating medical restrictions and limitations and estimating duration of recovery. As a Nurse Disability Consultant, you will acts a clinical resource for Group Protection benefit specialists and claim professionals.
Clarifies, interprets and/or evaluates medical information to assess appropriateness of current and ongoing restrictions / limitations and level of impairment.
Identifies pertinent clinical facts and answers questions in collaboration with benefits specialists and physician consultants.
Acts as a clinical resource to Group Protection claim professionals during claim meetings and as needed.
Recommends specific medical information needed to evaluate ongoing level of impairment and to facilitate optimal claim management.
Makes appropriate referrals to internal and external clinical resources (i.e. IME, FCE, Peer Reviews).
Discusses complex medical issues with health care providers as needed and documents outcomes of discussion.
Coordinates and partners with Vocational Rehabilitation Coordinators (VRC) and others to support with return to work services.
Effectively manages assigned caseload within department productivity goals
Demonstrates clear and concise verbal and written communication skills when interpreting medical information, documenting rationales for clinical opinions, clarifying restrictions and limitations, assisting with return to work and communicating with staff, management and other business stakeholders.
Contacts claimants, employers, and health care providers, as indicated.
Educates attending health care providers regarding the need for medical information to support restrictions and limitations.
Achieves and maintains professional continuing education units (CEUs) by attending educational seminars and other required Company educational activities (i.e. ethics, confidentiality)
Supports Senior Nurse Disability Consultants in providing training and mentoring to new claims staff, peers and/or other claim professionals.
Sets goals with management for personal and professional growth and reassesses throughout the year.
Acts as a role model and coach through early assessment of medical issues, work capacity, and RTW opportunities
4 Year/Bachelor’s Degree in Nursing
Current unrestricted RN License in the state where the position is based required
Educational experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred
Certified Disability Management Specialist (CDMS) or Associate Disability Management Specialist (ADMS), Certified Occupational Health Nurse (COHN), Certified Case Manager (CCM) designations preferred
3-5 years of nursing experience with preferred clinical nursing expertise in Emergency Room, Critical Care, Orthopedics, Coronary Care, or trauma.
Previous insurance industry experience preferred
A demonstrated track record of consistently meeting and/or exceeding performance expectations
Possesses a bias for action and avoids workplace distractions
Drives performance targets to completion
Proficient in Microsoft applications including Word, Excel, PowerPoint, and Outlook. Typing is proficient and accurate and at least average speed
This position may be subject to Company’s Political Contribution Policy. An offer of employment may be contingent upon disclosing to Company the details of certain political contributions. Company may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Company’s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.
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