Job Classification:

Operations - Insurance Operations

For over 100 years, Prudential’s diverse and talented employees have been committed to helping customers and their families grow and protect their wealth through a variety of products and services, including Group Insurance.   We are known for delivering on our promises and are recognized as a trusted brand and one of the world’s most admired companies.

The Business:

Prudential is a company of smart, ambitious professionals working together across a multitude of disciplines. Together, we are building a better financial future for our customers and our communities around the globe. At Prudential, we understand that a company is only as good as its people. This simple fact is central to all that we do.

The current EWA for this position is Fully Virtual. While this position does not require your on-site presence on a regular basis, depending on business preferences, there may be occasions where you are required to be on-site at a Prudential office.

What you can expect:

In this role, you will be reviewing medical documentation in case files to make determinations on medically supported restrictions and limitations for clients. Our clinicians work in collaboration with our claim’s teams, our physicians, our return-to-work coordinators, and vocational departments to resolve the best course for claim management.

Here are some of the responsibilities for the role:

• Review and assessment of primarily complex illness and injury claims.
• Identify restrictions and limitations based on physiological, psychological, and social factors to assist claim management staff in their claim handling activities.
• Assist in strategy as well as identifying appropriate utilization of additional clinical, vocational, or other resources which will require excellent analytical and critical thinking skills.
• Apply effective written and verbal communication skills to document clinical assessments; contact Treating Providers; engage in discussions with other resources including but not limited to Disability Claim Team Members, Clinical Peers, and Vocational Rehabilitation Counselor Resources.
• Demonstrate urgency and adaptability to address the demands of a fast-paced environment, while consistently achieving established quality and quantity performance standards.
• Ability to work independently with minimal direct supervision.

What you’ll need:

• Currently licensed RN or Nurse Practitioner.
• 3+ years of clinical experience preferred.
• Excellent time management and organizational skills.
• Possess excellent analytical and critical thinking skills to assist in strategy development.
• Effective written and verbal communication skills to document clinical assessment.

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What we offer you:

Prudential is required by state specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $76,000.00 to $125,400.00. Specific pricing for the role may vary within the above range based on many factors including geographic location, candidate experience, and skills.

• Market competitive base salaries, with a yearly bonus potential at every level. 

• Medical, dental, vision, life insurance, disability insurance, Paid Time Off (PTO), and leave of absences, such as parental and military leave. 

• 401(k) plan with company match (up to 4%). 

• Company-funded pension plan. 

• Wellness Programs including up to $1,600 a year for reimbursement of items purchased to support personal wellbeing needs. 

• Work/Life Resources to help support topics such as parenting, housing, senior care, finances, pets, legal matters, education, emotional and mental health, and career development.  

• Education Benefit to help finance traditional college enrollment toward obtaining an approved degree and many accredited certificate programs.  

• Employee Stock Purchase Plan: Shares can be purchased at 85% of the lower of two prices (Beginning or End of the purchase period), after one year of service. 

Eligibility to participate in a discretionary annual incentive program is subject to the rules governing the program, whereby an award, if any, depends on various factors including, without limitation, individual and organizational performance. To find out more about our Total Rewards package, visit Work Life Balance | Prudential Careers. Some of the above benefits may not apply to part-time employees scheduled to work less than 20 hours per week.