Salary Range: $45,000 - $105,000

We’ve Got You Under Our Wing

We are the duck. We develop and empower our people, cultivate relationships, give back to our community, and celebrate every success along the way. We do it all…The Aflac Way.

Aflac, a Fortune 500 company, is an industry leader in voluntary insurance products that pay cash directly to policyholders and one of America's best-known brands. Aflac has been recognized as Fortune’s 50 Best Workplaces for Diversity and as one of World’s Most Ethical Companies by Ethisphere.com.

Our business is about being there for people in need. So, ask yourself, are you the duck? If so, there’s a home, and a flourishing career for you at Aflac.

Work Designation. This is a remote role.

• This role will be remote. This means you will be expected to work from your home, within the continental US. If the role is remote, there may be occasions that you are requested to come to the office based on business need. Any requests to come to the office would be communicated with you in advance.

What does it take to be successful at Aflac?

• Acting with Integrity
• Communicating Effectively
• Pursuing Self-Development
• Serving Customers
• Supporting Change
• Supporting Organizational Goals
• Working with Diverse Populations

What does it take to be successful in this role?

• Extensive clinical experience/knowledge
• Knowledge of medical diagnoses and ICD-10 codes
• Strong investigative and analytical skills
• Strong customer service and advocacy skills
• Strong written and oral communication skills
• Strong organizational and time management skills
• Ability to analyze health care records in the context of functional capacity related to work demands
• Strong desire and ability to work in a team environment
• Flexibility and coachability in the context of organizational growth and process change and development
• Demonstrated ability to prioritize workload in a fast-paced environment, with proven organization and time management skills.

Education & Experience Required

• Bachelor’s Degree in Nursing or advanced degree in medicine, e.g. NP, PA, MD or DO
• 3 years of experience in the field of health care working directly with patients
• Current medical license in the state of residence

Or an equivalent combination of education and experience

Education & Experience Preferred

• 2 or more years of experience in disability management industry managing STD or LTD claims
• CDMS or CCM certifications
• Utilization Review Experience and/or experience using specific behavioral health criteria or protocols

Principal Duties & Responsibilities

• Serves as a clinical subject matter expert to disability case managers and provides well reasoned and timely clinical analyses related to functional impairment and work capacity
• Through a clinical advocacy approach the clinician partners with case managers on return-to-work plans via contacts with treating providers and employees as needed
• Assists in investigating and resolving inconsistencies in the level of employee functionality related to treating provider opinions and projections of incapacity and impairment
• Coordinates strategies to determine levels of employee functional capacity utilizing direct contact with treating providers and/or utilizing internal clinical resources (e.g. Medical guidelines, Independent Physician Advisor Reviews, internal impairment guides, round table reviews, etc.)
• Acts as a clinical consultant and resource to the Appeals Unit and attends short-term to long-term disability transition meetings as needed
• Provides continuing education for case management staff via mini-clinical lectures and assists in the development of clinical tools/guides/training under the direction of Medical Director
• Additional Responsibilities:
  • May act as a clinical resource to Claim Operations staff when handling claimants noted to be threatening harm to themselves or others
  • Assists in the development of clinical tools, templates, processes, and protocols under the direction of the Medical Director
  • Facilitates referrals to ancillary internal and external services, e.g. EAP, disease management programs, Advocacy, care managers, etc. as applicable
  • Coordinates and monitors quality of external physician advisor reviews or IME's as applicable
  • Identifies employee barriers in returning to work as well as identifying and prompting optimal health care to facilitate an appropriate and timely return-to-work plan and strategy
  • Strategizes with claimants, treating providers, and employers on possible accommodations or restriction to facilitate transitional return-to-work plans
• Performs other related duties as required

Total Rewards

This compensation range is specific to the job level and takes into account the wide range of factors that are considered in making compensation decisions including, but not limited to: education, experience, licensure, certifications, geographic location, and internal equity. The range has been created in good faith based on information known to Aflac at the time of the posting. Compensation decisions are dependent on the circumstances of each case. This salary range does not include any potential incentive pay or benefits, however, such information will be provided separately when appropriate. The salary range for this position is $45,000 - $105,000.

In addition to the base salary, we offer an array of benefits to meet your needs including medical, dental, and vision coverage, prescription drug coverage, health care flexible spending, dependent care flexible spending, Aflac supplemental policies (Accident, Cancer, Critical Illness and Hospital Indemnity offered at no costs to employee), 401(k) plans, annual bonuses, and an opportunity to purchase company stock. On an annual basis, you’ll also be offered 11 paid holidays, up to 20 days PTO to be used for any reason, and, if eligible, state mandated sick leave (Washington employees accrue 1 hour sick leave for every 40 hours worked) and other leaves of absence, if eligible, when needed to support your physical, financial, and emotional well-being. Aflac complies with all applicable leave laws, including, but not limited to sick and safe leave, and adoption and parental leave, in all states and localities.