Clinical Care Consultant; Registered Nurse

At One America, we deliver on promises when customers need us most. We believe the best way to serve our customers is to know that every individual, employee, family and business we work with has unique personal and financial goals. We keep our promises, so we can help them achieve their goals and realize their definition of financial success.

The Clinical Care Consultant is responsible for supporting One America’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 Care Consultants also work closely with claims associates to educate regarding medical conditions, treatment, & recovery to function.

• Conduct comprehensive clinical assessments of Short- and Long-Term Disability claims and Life Waiver of Premium.
• 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.
• Document claim files and systems in a clear and professional manner. Communicate effectively and professionally with a wide variety of peers and resources.

• Current & active Registered Nurse (RN) license in their state of residency required. BSN preferred.
• Experience in a behavioral health setting preferred
• Clinical experience in acute care setting.
• 2-5 years' clinical experience within claims organization preferred
• 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.

Salary Band: 06B

This selected candidate will be expected to work Hybrid in Portland, ME. We may consider remote work for candidates not local to Portland, ME. 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.

This Position is full-time and associate must be available to work Monday through Friday.

Consistent with applicable pay transparency laws, we disclose the compensation range for this position: $79,500 - $132.500 annually
. Actual compensation will be determined by factors such as education, experience, geographical location, and other job-related factors permitted by law. In addition to base pay, this role is eligible for an annual incentive program.

We offer a comprehensive total rewards package designed to support you both at work and l‑time and part‑time associates working 30 or more hours per week are generally eligible for benefits, including but not limited to:

• Medical & prescription, dental, vision insurance
• Health Savings Account & Flexible Spending Accounts
• Paid Time Off
• 10 weeks 100% paid parental leave (after completing 12 months of employment)
• 401(k) Plan with…