**Alternate Locations:** Work from Home
**Work Arrangement:** Work from Home
**Relocation assistance:** : is not available for this opportunity.
**Pay Range:** $63,100 - $137,900
**Requisition #:** 70248
**General Purpose of Job**
This role will act as a resource to claims teams to review, analyze, and interpret medical information related to behavioral health and substance abuse conditions in claims. They will assess ongoing interventions and functional capacity for psychiatric, social, psychological, and vocational areas. They will review clinical information to clarify diagnoses, evaluate severity of behavioral health and substance abuse conditions, validate medical restrictions/limitations, estimate duration of recovery.
**Duties and Responsibilities**
Discusses behavioral health issues with health care providers as needed and documents outcomes of discussion.
Acts as a behavioral health resource to claim professionals during claim meetings and behavioral health clinical forums as needed. Shares knowledge on early assessment of behavioral health issues, work capacity, and return to work opportunities.
Consults/Analyze on more complex assignments and/or projects for their assigned area(s) of responsibility.
Identifies pertinent behavioral health clinical facts and answers questions in collaboration with benefits specialists and physician consultants.
Clarifies, interprets, and/or evaluates behavioral health clinical information to assess appropriateness of current and ongoing restrictions / limitations and level of impairment.
Contacts claimants, employers, and health care providers to obtain pertinent information for clinical claims reviews.
Champions and enhances organizational initiatives by positively influencing and supporting change management and/or departmental/enterprise initiatives within assigned area(s) of responsibility.
Maintains knowledge on current and emerging developments/trends for assigned area(s) of responsibility, assesses the impact, and collaborates with management to incorporate new trends and developments in current and future solutions.
Educates attending health care providers regarding the need for behavioral health medical information to support restrictions and limitations.
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.
Provides and receives constructive feedback in a professional manner to/from internal/external customers
Makes appropriate referrals to internal and external clinical resources (i.e. IME, FCE, Peer Reviews).
Identifies and recommends process improvements that significantly reduce workloads or improve quality for their assigned area(s) of responsibility.
Provides coaching and guidance to claims partners regarding medical management.
Recommends specific information needed to evaluate ongoing level of impairment and to facilitate optimal claim management.
Serves as a resource to team members and applicable internal/external stakeholders on more complex assignments/projects for their assigned area(s) of responsibility.
Sets professional growth goals and takes initiative to reassess throughout the year.
**Additional Position Responsibilities**
Carries out duties in compliance with all state and federal regulations and guidelines. Complies with all company and site policies and procedures.
Makes a positive contribution as demonstrated by: - Making suggestions for improvement - Learning new skills, procedures and processes
Performs other duties as required.
Remains current in profession and industry trends.
Bachelors degree in Nursing or Masters degree in Human Services related field (preferred)
Registered Nurse - Current, unrestricted license in the state where the position is located. -Upon Hire
Licensure in Clinical Psychology or Social Work (LICSW or LCMHC), Licensed Professional Counselor (LPC), or Certified Case Manager (CCM) designation -Upon Hire
**Other Skills and Abilities**
A demonstrated track record of consistently meeting and/or exceeding performance expectations
Ability to perform under stress in cases of emergency, critical or hazardous situations.
Ability to work with others in a team environment.
Achieves and maintains professional continuing education units (CEUs) by attending educational seminars and other required LFG educational activities (i.e. ethics, confidentiality)
Demonstrated strong relationship management skills with internal clients (e.g. management, peers and colleagues); proven ability to develop collaborative approaches.
Demonstrates ability to identify and recommend processes improvements.
Demonstrates excellent organizational skills with the ability to prioritize workload and multi-task while maintaining strict attention to detail.
Demonstrates strong interpersonal skills with a collaborative style.
Demonstrates the ability to use sound judgment and discretion regarding confidential information.
Drives performance targets to completion
Finds common ground and can gain collaboration among management, colleagues and peers; can influence outcomes without directing or commanding.
Possesses a bias for action and avoids workplace distractions
Proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
Strong project management skills including, critical ability to coordinate and balance multiple projects in a time-sensitive environment, under pressure, and meeting deadlines.
Successfully completes regulatory and job training requirements.
Supports Behavioral Health Consultant II in providing training and mentoring to new claims staff, peers and/or other claim professionals.
3 - 5+ Years experience in behavioral health including 1 year in claims, disability management (STD/LTD), workers comp, utilization review, and/or behavioral health nurse case management. (Required )
**What's it like to work here?**
At Lincoln Financial Group, we love what we do. We make meaningful contributions each and every day to empower our customers to take charge of their lives. Working alongside dedicated and talented colleagues, we build fulfilling careers and stronger communities through a company that values our unique perspectives, insights and contributions and invests in programs that empower each of us to take charge of our own future.
**What's in it for YOU:**
+ A clearly defined career framework to help you successfully manage your career
+ Leadership development and virtual training opportunities
+ PTO/parental leave
+ Competitive 401K and employee benefits ([ Link removed ] - Click here to apply to Behavioral Health Consultant
+ Free financial counseling, health coaching and employee assistance program
+ Tuition assistance program
+ A leadership team that prioritizes your health and well-being; offering a remote work environment and flexible work hybrid situations
+ Effective productivity/technology tools and training
Work from Home : Employees will work from home and are not required to work in a Lincoln office on a regular basis.
**Lincoln will evaluate the following when setting the successful candidate's wage rate:**
• Prior work or industry experience.
• Education level to the extent education is relevant to the position.
• Unique skills
**About The Company**
Lincoln Financial Group, a Fortune 200 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 $324 billion in end-of-period account values as of June 30, 2021.
Ranked one of the Best Large Employers in America and Best Employers for Women by _Forbes_ magazine as well as one of _Newsweek's_ Most Responsible Companies, 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.
Lincoln is committed to creating a diverse and inclusive ([ Link removed ] - Click here to apply to Behavioral Health Consultant
environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
Lincoln Financial Group is a committed corporate citizen included on major sustainability indices including the Dow Jones Sustainability Index North America and FTSE4Good. Dedicated to diversity and inclusion, we earned perfect 100 percent scores on the Corporate Equality Index and the Disability Equality Index. Follow us on Facebook ([ Link removed ] - Click here to apply to Behavioral Health Consultant
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**Be Aware of Fraudulent Recruiting Activities**
If you are interested in a career at Lincoln, we encourage you to review our current openings and apply on our website. Lincoln values the privacy and security of every applicant and urges all applicants to diligently protect their sensitive personal information from scams targeting job seekers. These scams can take many forms including fake employment applications, bogus interviews and falsified offer letters.
Lincoln will not ask applicants to provide their social security numbers, date of birth, bank account information or other sensitive information in job applications. Additionally, our recruiters do not communicate with applicants through free e-mail accounts (Gmail, Yahoo, Hotmail) or conduct interviews utilizing video chat rooms. We will never ask applicants to provide payment during the hiring process or extend an offer without conducting a phone, live video or in-person interview. Please contact Lincoln's fraud team at [ Email address blocked ] - Click here to apply to Behavioral Health Consultant
if you encounter a recruiter or see a job opportunity that seems suspicious.
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, Veteran 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
This Employer Participates in E-Verify. See the E-Verify ([ Link removed ] - Click here to apply to Behavioral Health Consultant
Este Empleador Participa en E-Verify. Ver el E-Verify ([ Link removed ] - Click here to apply to Behavioral Health Consultant
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. 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.
- Attention To Detail
- Behavioral Medicine
- Business Relationship Management
- Case Management
- Certified Nurse Practitioner
- Change Management