Senior Clinical Consultant (Remote)

About this role

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/ A ppeal s) and   products,   action planning management, and Guardian systems .    T his 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.  

Y ou are :  

A   highly motivated   and reliable   individual   who   can   work with   varying levels of   supervision – independently or collaboratively.   You   are   detail-oriented a nd 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  

• P r oven 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   t o 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 d elegate, distribute ,   and monitor workloads within the department to meet   departmental   regulations, i mprove efficiency and reduce or   eliminate   backlogs  

• Assist Team Manager when needed to   m onitor   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.

• S upport training initiatives by   identifying   knowledge   gaps and   providing ideas   for   improvement  

• S upport   Clinicians   in   develop ing   efficient desk & time management skills  

• C ollaborate with peers and leadership to ensure consistency with mentoring and coaching  

• Co-f acilitate 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 - $113,310.00 The 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 opportu

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