Clinical Nurse Consultant, Individual Claims

United States Job Openings

Mutual of Omaha

FULL TIME

October 19, 2024

Location: Remote
Work Type: Full Time Regular
Job No: 503454
Categories: Claims/Claims Processing
Application Closes: Open Until Filled

As our Clinical Nurse Consultant, you’ll play a critical role on our LTC claims team, reviewing medical information, writing summaries, and providing key insights on claimants' functional capacity. Your strong medical knowledge, documentation skills, and ability to draw conclusions from medical records will ensure accurate and efficient claim processing.

WHAT WE CAN OFFER YOU:

Estimated Salary: $70,000 - $85,000 plus annual bonus opportunity.
Remote opportunity.
Benefits and Perks, 401(k) plan with a 2% company contribution and 6% company match.
Regular associates working 40 hours a week can earn up to 15 days of vacation each year.
Regular associates receive 11 paid holidays in 2024, which includes 2 floating holidays that are added to your prorated personal time to be used at your discretion.
Regular associates are provided sick leave through the use of personal time. Associates working 40 hours a week can receive up to 40 hours of personal time in 2024, which is prorated based on the start date. Additionally you will receive two floating holidays in 2024 by way of personal time that may be used at your discretion.
Applicants for this position must not now, nor at any point in the future, require sponsorship for employment.

WHAT YOU'LL DO:

Review medical records, summarize key findings, and determine if they support Activities of Daily Living (ADL) restrictions.
Use your clinical expertise to assess physical and cognitive loss, drawing sound conclusions on claimants’ functional capacity.
Collaborate with claims associates and medical staff, offering guidance on complex cases while educating others on medical conditions.
Maintain open communication with policyholders, providers, and other stakeholders to ensure clarity and consistency in claim reviews.
Leverage critical thinking and judgment to process information quickly in a fast-paced environment, ensuring accuracy and compliance.

WHAT YOU’LL BRING:

RN License (required) with at least 5 years of active clinical experience—preferably in gerontology, general medical, or surgical backgrounds.
Strong documentation and critical thinking skills with an ability to interpret medical records holistically.
Excellent writing and communication abilities, with a desire to educate and support claims associates.
A thorough understanding of functional capacity and the ability to assess how medical conditions affect daily living.
Ability to work in a fast-paced corporate environment, making quick and sound decisions.
You promote a culture of diversity and inclusion, value different ideas and opinions, and listen courageously, remaining curious in all that you do.
Able to work remotely with access to a high-speed internet connection and located in the United States or Puerto Rico.

PREFERRED:

Bachelor's Science Nursing (BSN) is preferred

We value diverse experience, skills, and passion for innovation. If your experience aligns with the listed requirements
If you have questions about your application or the hiring process, email our Talent Acquisition area at careers@mutualofomaha.com. Please allow at least one week from time of applying if you are checking on the status.

Need help? Email Us

Great place to work

Together we achieve greatness. Not only is this a core value, but it’s also representative of the kind of place we are — built by the strength and integrity of our employees. It’s why we’re named a “Great Place to Work”.

An inclusive culture

Surround yourself with an authentic and inclusive culture. Your strengths and differences will be valued and celebrated by a diverse community of co‑workers.

We regret to inform you that this job opportunity is no longer available as it has expired

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