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Alternate Locations: Omaha, NE (Nebraska)Relocation assistance is not available for this opportunity.Requisition #61581About the CompanyLincoln Financial Group, a Fortune 250 company with over 10,000 employees, provides advice and solutions that help empower Americans to take charge of their financial lives with confidence. Our core business areas — Life Insurance, Annuities, Retirement Plan Services and Group Protection — focus on supporting, preserving and enhancing over 17 million customer’s lifestyles and retirement outcomes.Headquartered in Radnor, Pennsylvania, Lincoln Financial Group is the marketing name for Lincoln National Corporation (NYSE: LNC) and its affiliates. The company had $253 billion in assets under management as of December 31, 2017.Ranked one of the Best Large Employers in America by Forbes magazine, Lincoln Financial Group makes a serious investment in our employees’ futures through a broad range of wealth accumulation and protection plans, health and wellness programs, and career development resources designed to help each individual reach their personal and professional goals.The RoleAs a Nurse Case Manager, you will be responsible for reviewing, analyzing and interpreting medical information available in disability claims. You will be evaluating medical information to clarify diagnoses, evaluating the severity of medical conditions, validating medical restrictions and limitations and estimating duration of recovery. You will act a clinical resource for our benefit specialists and claim professionals.Functional ResponsibilitiesClaim Consultation
Clarifies, interprets and/or evaluates medical information to assess appropriateness of current and ongoing restrictions / limitations and level of impairment.
Identifies pertinent clinical facts and answers questions in collaboration with benefits specialists and physician consultants.
Acts as a clinical resource to Group Protection claim professionals during claim meetings and as needed.
Recommends specific medical information needed to evaluate ongoing level of impairment and to facilitate optimal claim management.
Makes appropriate referrals to internal and external clinical resources (i.e. IME, FCE, Peer Reviews).
Discusses complex medical issues with health care providers as needed and documents outcomes of discussion.
Coordinates and partners with Vocational Rehabilitation Coordinators (VRC) and others to support with return to work services.
Effectively manages assigned caseload within department productivity goals
Communication
Demonstrates clear and concise verbal and written communication skills when interpreting medical information, documenting rationales for clinical opinions, clarifying restrictions and limitations, assisting with return to work and communicating with staff, management and other business stakeholders.
Contacts claimants, employers, and health care providers, as indicated.
Training
Educates attending health care providers regarding the need for medical information to support restrictions and limitations.
Achieves and maintains professional continuing education units (CEUs) by attending educational seminars and other required LFG educational activities (i.e. ethics, confidentiality)
Supports Senior Nurse Disability Consultants in providing training and mentoring to new claims staff, peers and/or other claim professionals.
Sets goals with management for personal and professional growth and reassesses throughout the year.
Acts as a role model and coach through early assessment of medical issues, work capacity, and RTW opportunities
RequirementsEducation
4 Year/Bachelor’s Degree in Nursing
Current unrestricted RN License in the state where the position is based required
Educational experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management preferred
Certified Disability Management Specialist (CDMS) or Associate Disability Management Specialist (ADMS), Certified Occupational Health Nurse (COHN), Certified Case Manager (CCM) designations preferred
Experience
3-5 years of nursing experience with preferred clinical nursing expertise in Emergency Room, Critical Care, Orthopedics, Coronary Care, or trauma.
Previous insurance industry experience preferred
A demonstrated track record of consistently meeting and/or exceeding performance expectations
Possesses a bias for action and avoids workplace distractions
Drives performance targets to completion
Proficient in Microsoft applications including Word, Excel, PowerPoint, and Outlook. Typing is proficient and accurate and at least average speed
This position may be subject to Lincoln’s Political Contribution Policy. An offer of employment may be contingent upon disclosing to Lincoln the details of certain political contributions. Lincoln may decline to extend an offer or terminate employment for this role if it determines political contributions made could have an adverse impact on Lincoln’s current or future business interests, misrepresentations were made, or for failure to fully disclose applicable political contributions and or fundraising activities.Any unsolicited resumes/candidate profiles submitted through our web site or to personal e-mail accounts of employees of Lincoln Financial Group are considered property of Lincoln Financial Group and are not subject to payment of agency fees.Lincoln Financial Group (“LFG”) is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Applicants are evaluated on the basis of job qualifications. If you are a person with a disability that impedes your ability to express your interest for a position through our online application process, or require TTY/TDD assistance, contact us by calling 260-455-2558.#P3Lincoln Financial Group ("LFG") is an Equal Opportunity employer and, as such, is committed in policy and practice to recruit, hire, compensate, train and promote, in all job classifications, without regard to race, color, religion, sex (including pregnancy), age, national origin, disability, sexual orientation, gender identity and expression, veterans status, or genetic information. Opportunities throughout LFG are available to employees and applicants and are evaluated on the basis of job qualifications. We have a drug free work environment and we perform pre-employment substance abuse testing.
