Alternate Locations: Dover, NH (New Hampshire)
Relocation assistance is not available for this opportunity.
About the Company
Lincoln 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.
This position will be responsible for reviewing, analyzing and interpreting available medical information that is related to behavioral health and substance abuse conditions identified in short term and long term disability claims. The Behavioral Health Consultant will also assess ongoing interventions and functional capacity in the following areas: psychiatric, social, psychological, and vocational. Clinical information will be reviewed to clarify diagnoses, evaluate the severity of behavioral health and substance abuse conditions, validate medical restrictions and limitations, estimate duration of recovery, as well as, collaborate with the interdisciplinary team regarding a return-to-work plan.
- Maintains knowledge on current and emerging behavioral health developments/trends for assigned area(s) of responsibility, assesses the potential impact, and collaborates with management to incorporate new trends and developments in current and future solutions.
- Manages assigned caseload of complex cases; applies specialized training/knowledge to the assessment of behavioral health cases; provides technical insight and advice.
- Review and analyze data found within medical records and treatment plans in comparison to duration control guidelines; seeks clarification for functional inconsistencies with healthcare providers and/or claimants reports.
- Champions and enhances organizational initiatives by positively influencing and supporting change management and/or departmental/enterprise initiatives within assigned area(s) of responsibility.
- Serves as a resource to team members and applicable internal/external stakeholders on more complex assignments/projects for his/her assigned area(s) of responsibility.
- Identifies and recommends process improvements that significantly reduce workloads or improve quality for his/her assigned area(s) of responsibility.
- Readily available to consult with interdisciplinary team on more complex assignments and/or projects for his/her assigned area(s) of responsibility.
- Prepares clear and concise verbal and written communications in layman’s terms when interpreting medical information, documenting rationales for clinical opinions, clarifying restrictions and limitations and assisting with return to work.
- Acts as a resource, shares knowledge and coaches other nurses and internal stakeholders through early assessment of behavioral health issues, work capacity, and return to work (RTW) opportunities.
- Achieves and maintains professional continuing education units (CEUs) by attending educational seminars and other required LFG educational activities (i.e. ethics, confidentiality).
- Provide claims examiner with recommendations for specific behavioral health medical information needed to evaluate ongoing level of impairment and helps to facilitate and promote optimal claim management.
- Educates attending health care providers regarding the need for behavioral health medical information to support restrictions and limitations.
- Supports team members 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 takes the initiative to reassess throughout the year.
- Makes timely and appropriate referrals to internal and external clinical resources.
- Master’s Degree in Clinical Psychology or Social Work.
- Registered Nurse. Will accept associate degree or higher with current RN state license. BSN, or 4 years of applicable behavioral health experience preferred.
- 1+ years of experience in claims, disability management, workers compensation, utilization review and/or nurse case management preferred.
- 2+ years of experience in inpatient or intensive outpatient or outpatient therapy in a clinical setting.
- Licensure in Clinical Psychology or Social Work.
- Behavioral health disability insurance or workers compensation case management, private rehabilitation risk management, occupational health, rehabilitation facility, or utilization review is highly preferred.
- Solid verbal and written communication skills.
- Analytical and critical-thinking skills.
- Broad technical knowledge of medical conditions, prognosis, and associated treatment.
- Basic understanding of the disability contract, its key provisions, and the implication of those provisions.
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.
Please note: if your initial application passes a first review, you'll receive a final application link via email.