[Hiring] Long Term Care Clinical Nurse Consultant @Careers Mutual Of Omaha

Role Description

We are seeking a knowledgeable and detail-oriented Clinical Nurse Consultant – Long-Term Care to provide clinical expertise and support claims management through comprehensive medical reviews, clinical analysis, and return-to-work and recovery guidance. In this role, you will evaluate medical information related to claims, identify appropriate restrictions and limitations, and provide recommendations that support effective claim outcomes and recovery opportunities.

The ideal candidate combines strong clinical judgment, analytical skills, and a commitment to quality care with the ability to educate claims professionals, collaborate with business partners, and monitor vendor performance.

Qualifications

• Licensed Registered Nurse (RN) with knowledge or experience in disability case management, elder care, long-term care, critical illness, early intervention, treatment mechanisms, claims procedures, or related areas.
• Bachelor of Science degree preferred; an associate degree with relevant credentials or experience will be considered.
• Demonstrates sound judgment, initiative, creativity, critical thinking, strong analytical and problem-solving skills, and confident decision-making abilities.
• Possesses excellent written and verbal communication, interpersonal, facilitation, and organizational skills.
• Works independently, manages multiple cases and deadlines, and adapts to changing priorities.
• Prioritizes customer needs while ensuring high-quality, timely, and compliant claim decisions.
• Able to work remotely with access to a high-speed internet connection and located in the United States.

Requirements

• Analyze, interpret, and validate medical records and reports.
• Identify restrictions and limitations; determine recovery timelines; recommend next steps.
• Support appropriate claim decisions and case management strategies.
• Coordinate and monitor disability case management and long-term care assessment services.
• Evaluate quality and outcomes, identify cost savings, and maintain a nationwide database of available services and resources.
• Partner with claimants, families, physicians, medical facilities, attorneys, insurers, employers, and other stakeholders.
• Recommend external medical consultations and evaluate alternative care options.
• Develop and deliver clinical training for claims associates and stay current on industry trends.
• Participate in professional seminars and develop innovative care programs to improve outcomes.

Benefits

• Estimated Salary: Minimum: $74,800 MidPoint: $96,150 Maximum: $117,500.
• 401(k) plan with a 2% company contribution and 6% company match.
• Work-life balance with vacation, personal time, and paid holidays.