Description
At OneAmerica Financial, our purpose is to create more certainty for our customers that leads to better moments, every day. Our commitment is to advance stability and growth in every solution and relationship. We deliver financial strength that builds for generations, and we are always aspiring, looking ahead, and collaborating to achieve more, together. Come be a part of this journey with us as we champion lives!
Job Summary
The Clinical Consultant is responsible for supporting OneAmerica’s Claims operation acting both in a consultative nature during claim discussions and to provide comprehensive reviews of medical information. They are responsible for discussing and documenting an assessment of a claimant’s potential for recovery and work function. Clinical Consultants also work closely with claims associates to educate regarding medical conditions, treatment, & recovery to function.
Primary duties may include, but are not limited to
- Current with medial technology, conditions, treatments and expected recovery and prognosis of medical conditions. Maintains expertise to educate others and suggest process change when updates occur in the medical industry.
- Conduct comprehensive clinical assessments of Long-Term Care, Life Waiver of Premium, Short- and Long- Term Disability claims.
- Participate in multidisciplinary meetings as the clinical resource. Provide answers regarding medical issues, and functionality. Provide clear and complete clinical short and long-term clinical recommendations.
- Assist claims associates with preparing information needed for peer reviews, IMEs, or FCEs by providing guidance around the specialty of provider to utilize and questions to ask of that provider.
- Collaborate with internal resources to assist the claims team in developing a sound action plan for a claim.
- Provide support and training to the claims department around specific medical conditions and clinical trends to improve medical knowledge.
- Document claim files and systems in a clear and professional manner. Communicate effectively and professionally with a wide variety of peers and resources.
- Ability to influence and teach others. Use facilitation skills in a variety of discussions.
- Work in a self-directed way being able to make independent judgments and decisions.
- Prioritize and organize work independently while keeping the team and broader organizational needs in mind.
- Strong research, analytical, critical thinking, problem solving skills and decision-making skills
- Thrives in a fast-paced, service-oriented work environment with the need to pivot priorities according to needs of the business.
- Computer skills with strong proficiency in Microsoft programs especially Word, Excel, Outlook email and Teams web-conferencing and messaging.
- Identify opportunities for process improvements.
- Participate in projects, as needed, within the department.
- Maintains a level of participation and commitment to OAs security, privacy and ethic policies.
Job Requirements
Required Education and/or Certifications
- Current & active Registered Nurse (RN) license in their state of residency required. BSN preferred.
Required Work Experience
- Clinical experience in acute care setting.
- 1-year clinical experience in claims organization preferred, but not required.
Salary Band: 06B
This role is Hybrid for candidates local to Indianapolis, IN or Portland, ME. Hybrid would include 3 days in either Indianapolis or Portland office. We will consider candidates not local to Portland, ME or Indianapolis, IN for fully remote work schedule.
The candidate will also be expected to physically return to the office in CA, WI, IN or ME as business needs dictate or for team-building and collaboration.
If you are offered and accept this position, please be advised that OneAmerica Financial does not have any offices located in the State of New York and OneAmerica Financial associates are not permitted to work remotely in the State of New York.
Disclaimer: OneAmerica Financial is an equal opportunity employer and strictly prohibits unlawful discrimination based upon an individual’s race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law.
For All Positions
Because this position is regulated by the Violent Crime Control and Law Enforcement Act, if an offer is made, applicants must undergo mandated background checks as a condition of employment. Such background checks include criminal history. A conviction is not necessarily an absolute bar to employment. Consistent with applicable regulatory guidelines and law, factors such as the age of the offense, evidence of rehabilitation, seriousness of violation, and job relatedness are considered.
To learn more about our products, services, and the companies of OneAmerica Financial, visit oneamerica.com/companies.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.