Nurse Consultant

Responsibilities:

• Work telephonically with claimants, physicians, employers, and customers to ensure strict adherence in determining functional abilities.
• Correlate job duties, functional capability, and the definition of disability per contact.
• Assess medical records and treatment plans for all STD/LTD/FML claims, comparing duration control guidelines and clarifying functional inconsistencies to determine residual abilities.
• Provide recommendations regarding claimants' current or potential functional abilities and develop a goal-focused return to work plan.
• Provide education on medical and disability issues for all STD/LTD/FML Claim Specialists.
• Prepare and implement Return to Work Plans and address barriers for return to work for all STD/LTD/FML claims.
• Facilitate communication among employee, physician, and employer, and partner with all parties in the medical treatment plan.
• Assess and facilitate ongoing interventions covering medical, social, psychological, and vocational areas for all STD/LTD/FML claims and refer as appropriate.
• Complete special projects as assigned by the manager.
• Work with management to identify and address continuing education needs.
• Serve as a visible leader in translating the company's vision and values into practical business strategies.
• Demonstrate knowledge of, and support, the company's Disability mission, vision, value statements, standards, policies and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.

Requirements:

• Minimum of 3 years of experience in clinical nursing, working with an adult population.
• Must possess excellent verbal and written communication skills.
• Must possess excellent analytical decision-making, problem-solving, and critical thinking skills.
• Must be able to prioritize work and meet deadlines.
• Ability to work independently and in a team environment.
• Ability to engage in effective negotiations and conflict resolution.
• Ability to work effectively and build relationships with various levels throughout the company.
• Ability to represent self and company confidently and knowledgeably to external partners both verbally and in writing.
• Knowledge of medical terminology and procedures, CPT and ICD 9 coding.
• Proficient in use of multiple systems and technology resources.
• Associate degree required, Bachelor degree preferred.
• Current LPN or RN licensure – active and in good standing.

Preferred Skills:

• Experience in disability insurance or workers compensation case management, private rehabilitation risk management, occupational health, rehabilitation medicine, or home health care is highly preferred.