Clinical Consultant Details

Clinical Consultant

Sun Life - Wellesley Hills, MA

Employment Type : Full-Time

You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll have new and exciting opportunities to make life brighter for our Clients - who are at the heart of everything we do. Discover how you can make a difference in the lives of individuals, families and communities around the world.

Job Description:

At Sun Life, we look for energetic, optimistic people who want to make life brighter for our Clients. We understand the value of diverse cultures, perspectives, and identities, and want you to bring your full and authentic self to work. Every day, you’ll be empowered and challenged by working with dynamic colleagues to find new and innovative ways to make Sun Life the best benefits company in America.

Job Summary:

Sun Life operates with a Work Is Healthy (WisH) approach for disability claims management. As a Clinical Consultant within our Clinical Services team, you will apply your clinical expertise as a member of an interdisciplinary team that focuses on returning clients to optimal levels of productivity. This role does not involve hands-on assessment or direct care. This is a remote role.

What you will do:

• Conduct comprehensive clinical assessments of disability claims that are referred in different venues.
• Provide clarification of medical information and/or interpret medical reports (IMEs/FCEs, hospital and office records, and health care provider’s (HCP) calls and letters) and evaluate restrictions and limitations to assess current and ongoing level of impairment.
• Gather pertinent facts and answer questions in collaboration with claims professionals.
• Apply current clinical knowledge to medical data regarding diagnosis, treatment, prognosis, and impairment.
• Participate proactively through early assessment of medical conditions, functional capacity, and return to work (RTW) opportunities
• Provide whole person analysis, documenting rationale for opinions and recommended next steps.
• Make appropriate decisions and takes action to obtain additional medical information and/or referral to the appropriate resource, such as physician, claims professional, or vocational resource.
• Provide input and assistance to identify and collect pertinent medical information through outreach communications with attending physicians, claimants/insureds, and employers.
• Assist with urgency in providing support to claims professionals to determine claim direction and facilitate next steps.
• Outreach to health care provider (HCP), insured, or as indicated to discuss complex medical issues and document outcomes of discussion.
• Coordinate with Vocational Rehabilitation Consultant (VRCs) and others in regard to return-to-work services.
• Evaluate each claim file for RTW opportunities and partners with the VRC to develop RTW plans as indicated.
• Partner with VRC to identify functional capabilities for alternative occupations/job duties.
• Provide consultation and education to peers and a variety of other business partners.

What you will need to succeed:

• Ability to work with a diverse range of people
• Attention to detail with documentation, reporting and communication
• Ability to communicate effectively and professionally with a wide variety of both internal and external Sun Life business partners, peers and resources
• Excellent facilitation and presentation ability
• Self-directed with an ability to work independently and make independent judgements and decisions
• Strong organizational skills, including the ability to prioritize work and multi-task
• Exceptional research, analytical, critical thinking, problem solving and decision-making skills
• Ability to thrive in a fast-paced, service-oriented environment
• Strong computer skills
• Drive to continuously learn, build, and grow professionally

Required Education and Experience:

• Active and valid RN License
• Specialty certification such as CCM or CRRN is preferred
• 2+ years clinical experience working with an adult population
• Experience in rehabilitation setting, Occupational Health, Case/Care Management, Disability Insurance, Group Benefits or Workers Compensation a plus
• Demonstrated ability to work in a deadline-oriented environment managing multiple priorities
• Proficiency in Microsoft suite tools including Excel, Word and PowerPoint

What is in it for you?

• Excellent benefits with generous vacation and sick time, 401K match, noncontributory retirement plan, Paid Family Medical Leave, sabbatical program and much more
• Friendly, collaborative and inclusive culture
• Our agile work environment allows our employees the flexibility to give and feel their best at work

It is the policy of SLF U.S. that we will recruit, hire, train, and promote persons in all job titles, and ensure that all other personnel actions are administered, without regard to age, race, color, religion, national origin, ancestry, gender, sex (including but not limited to pregnancy, childbirth, or breastfeeding), sexual orientation, gender identity or expression, military or veteran status, physical or mental disability, medical condition, genetic information, marital status, or other legally protected status, and we will ensure that all employment decisions are based only on valid job requirements.

If you are a Colorado resident, the minimum starting salary for this position will be $72,600 annually. Sun Life will consider various factors in determining the actual pay including your skills, qualifications and experience. This position is also eligible for a broad range of competitive benefits including a choice of company-subsidized medical plans, consisting of network-based plans and plans offering the freedom to go to any provider and two company-subsidized dental plans. We also provide company-paid Basic Life and Accidental Death and Dismemberment (AD&D) insurance and Optional Life Insurance that you may purchase for additional coverage. We offer a very generous Paid Family & Medical Leave program, LTD and attractive vacation and sick time. We provide voluntary supplemental health programs such as Accident and Hospital insurance and Critical illness and Cancer insurance. Tax-advantaged accounts include Health Savings Accounts, Health Care and Dependent Care FSA accounts and Commuter Benefit accounts. Our 401(k) plan consists of a company match and employer sponsored contributions.

Sun Life Financial is a leading provider of group insurance benefits in the U.S., helping people protect what they love about their lives. More than just a name, Sun Life symbolizes our brand promise of making life brighter – for our customers, partners, and communities. Join our talented, diverse workforce and launch a rewarding career. Visit us at www.sunlife.com/us to learn more

At Sun Life we strive to create a flexible work environment where our employees are empowered to do their best work. Several flexible work options are available and can be discussed throughout the selection process depending on the role requirements and individual needs.

For applicants residing in California, please read our employee California Privacy Policy and Notice. California Privacy Policy and Notice.

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