Senior Clinical Consultant (Remote)
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AI Summary
The Senior Clinical Consultant will work in partnership with Clinical and Vocational Leaders to provide ongoing coaching and oversight to Clinical Consultants and will serve as clinical subject matter expert in all lines of business (STD/LTD/Appeals) and products, action planning management, and Guardian systems. This incumbent will have a strong clinical and client focus to assist in ensuring the fair and accurate assessments of medically supported functional abilities. They will assist in cultivating talent and foster an environment of continuous learning. They will promote organizational excellence by demonstrating leadership, problem-solving behaviors, and viewing challenges as opportunities. This individual will work with the Clinical Team Manager to drive performance and ensure the team meets their goals. They will effectively communicate & explain departmental initiatives and changes as they relate to organizational goals & strategies. They will assist the Clinical Team Manager in managing and resolving issues that come up related to clinical processes, claim management activities, customer inquiries, and quality.
You are:
A highly motivated and reliable individual who can work with varying levels of supervision – independently or collaboratively. You are detail-oriented and a decisive decision maker who can manage multiple priorities at the same time with a positive attitude.
You have:
A minimum of 5 years of (STD, LTD, Appeals) claim experience, minimum of 2 years disability experience
A minimum of 5 years in direct patient care settings
BSN and CCM preferred
Excellent verbal and written communication skills and presentation skills
Ability to exercise independent & sound judgment in decision making
Strong problem-solving, analytical, clinical, and information research skills
Excellent time management & organizational skills
Demonstrated ability to multi-task with the ability to manage continually changing priorities and the ability to prioritize work based on customer service needs and departmental regulations
The ability to remain flexible due to changing business needs
Proven ability to mentor and coach
Proficiency in MS Word, Excel, PowerPoint, DCMS, Claim Facts, and iProcess
You will:
Train and mentor all new Clinical Consultants
Provide ongoing training, coaching and development to all Clinical Consultant members
Organize and present at least one Clinical Training session for the Claims teams over the course of a year
Work with Team Manager to delegate, distribute, and monitor workloads within the department to meet departmental regulations, improve efficiency and reduce or eliminate backlogs
Assist Team Manager when needed to monitor caseloads, productivity, and participate in calibration sessions with our Clinical CMA and provide feedback to leadership and team members
Oversee external vendor utilization within team
Leverage knowledge and skills to flex and assist the overall team meet its goals, (i.e., assist with STD/LTD/ Appeals, flex and assist if needed)
Collaborate with claims partners to resolve conflicts and establish procedures that promote clinical claim management accuracy and improved customer service
Address escalated customer inquiries and formal complaints. Senior BHCM will also be first point of contact for SI or mental health crisis calls.
Support training initiatives by identifying knowledge gaps and providing ideas for improvement
Support Clinicians in developing efficient desk & time management skills
Collaborate with peers and leadership to ensure consistency with mentoring and coaching
Co-facilitate team meetings to share best practices, workflow changes, trends, and insights in alignment with Group benefits strategies
Provide desk coverage for leadership as needed
When not engaged in the above activities are expected to meet the same metrics and performance objectives as a Clinical Consultant
Reporting Relationships
As our Senior Clinical Consultant, you will report to a Clinical and Vocational Team Manager, who reports to the Head of Disability Clinical and Vocational Organization
Location
Flexible – work primarily from home. May be expected to come into a Guardian work location occasionally, as determined by their people leader.
Travel
Occasional 0-10% of the time.
Salary Range:
$68,970.00 - $113,310.00The salary range reflected above is a good faith estimate of base pay for the primary location of the position. The salary for this position ultimately will be determined based on the education, experience, knowledge, and abilities of the successful candidate. In addition to salary, this role may also be eligible for annual, sales, or other incentive compensation.
Our Promise
At Guardian, you’ll have the support and flexibility to achieve your professional and personal goals. Through skill-building, leadership development and philanthropic opportunities, we provide opportunities to build communities and grow your career, surrounded by diverse colleagues with high ethical standards.
Inspire Well-Being
As part of Guardian’s Purpose – to inspire well-being – we are committed to offering contemporary, supportive, flexible, and inclusive benefits and resources to our colleagues. Explore our company benefits at www.guardianlife.com/careers/corporate/benefits. Benefits apply to full-time eligible employees. Interns are not eligible for most Company benefits.
Equal Employment Opportunity
Guardian is an equal opportunity employer. All qualified applicants will be considered for employment without regard to age, race, color, creed, religion, sex, affectional or sexual orientation, national origin, ancestry, marital status, disability, military or veteran status, or any other classification protected by applicable law.
Accommodations
Guardian is committed to providing access, equal opportunity and reasonable accommodation for individuals with disabilities in employment, its services, programs, and activities. Guardian also provides reasonable accommodations to qualified job applicants (and employees) to accommodate the individual's known limitations related to pregnancy, childbirth, or related medical conditions, unless doing so would create an undue hardship. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact MyHR@glic.com. Please note: this resource is for accommodation requests only. For all other inquires related to your application and careers at Guardian, refer to the Guardian Careers site.
Visa Sponsorship
Guardian Life is not currently or in the foreseeable future sponsoring employment-based visas (e.g., such as an H-1B). In order to be a successful applicant, you must be legally authorized to work in the United States, without the need for employer sponsorship/support now or at any time in the future.
Notice Regarding Guardian’s Use of Artificial Intelligence in Recruitment
As part of Guardian’s job application process, Guardian may use artificial intelligence tools (“AI Tools") to automate the sorting and filtering of information provided by applicants as part of its preliminary screening. This preliminary screening may be used to help identify applicant materials and resumes relative to their indication that the applicant meets the requirements for the specific job for which they are applying, as specified in the listing posted on Guardian’s jobs website (Careers at Guardian at https://www.guardianlife.com/careers). At Guardian, we do not use AI Tools to substantially assist or replace human judgment or discretionary decision making in our hiring process. All hiring decisions will be made by Guardian colleagues.
Please be aware that if you apply for a specific position with Guardian, you will have the choice of opting out of Guardian’s use of AI Tools during the job application process. If you would like to request an alternative process that does not utilize AI Tools or would like to request a reasonable accommodation, within ten business days of your position application, you must email your request to MyHR@glic.com, making sure to provide your name and job requisition identification number. Guardian will retain your applicant materials and resume and all information therefrom in accordance with Guardian’s document retention policy, a copy of which you may request via MyHR@glic.com.
Additionally, at applicable times, Guardian will make public the most recent bias audit results for such AI tools, which may be found here.
Current Guardian Colleagues: Please apply through the internal Jobs Hub in Workday.
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