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Clinician Reviewer
<span class="jobdescription"><p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">Salary Range: </span></strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">$80,000 - $95,000</span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">Job Posting End Date: </span></strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">October 29th 2025</span></p> <p style="margin:0.0in;background-color:white;font-size:12.0pt;font-family:'Times New Roman', serif"><strong><span style="font-family:Arial, sans-serif;color:#242424"> </span></strong></p> <p style="margin:0.0in;background-color:white;font-size:12.0pt;font-family:'Times New Roman', serif"><strong><span style="font-family:Arial, sans-serif;color:#242424">We’ve Got You Under Our Wing</span></strong></p> <p style="margin:0.0in;background-color:white;font-size:12.0pt;font-family:'Times New Roman', serif"><span style="font-family:Arial, sans-serif;color:#242424">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…<em>The Aflac Way</em>.</span></p> <p style="margin:0.0in;background-color:white;font-size:12.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;background-color:white;font-size:12.0pt;font-family:'Times New Roman', serif"><span style="font-family:Arial, sans-serif;color:#242424">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. </span></p> <p style="margin:0.0in;background-color:white;font-size:12.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;background-color:white;font-size:12.0pt;font-family:'Times New Roman', serif"><span style="font-family:Arial, sans-serif;color:#242424">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.</span></p> <p style="margin:0.0in;background-color:white;font-size:12.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><u><span style="font-size:12.0pt;font-family:Arial, sans-serif">Worker Designation</span></u></strong><span style="font-size:12.0pt;font-family:Arial, sans-serif"> – This role is a <strong><u>remote</u></strong> role. 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.</span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">What does it take to be successful at Aflac?</span></strong></p> <ul style="margin-bottom:0.0in;margin-top:0.0px"> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Acting with Integrity</span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Communicating Effectively</span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Pursuing Self-Development</span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Serving Customers</span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Supporting Change</span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Supporting Organizational Goals</span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Working with Diverse Populations</span></li> </ul> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif"> </span></strong></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">What does it take to be successful in this role?</span></strong></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Extensive clinical experience/knowledge. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Knowledge of medical diagnoses and ICD-10 codes. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Strong investigative and analytical skills. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Strong customer service and advocacy skills. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Strong written and oral communication skills. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Strong organizational and time management skills. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Ability to analyze health care records in the context of functional capacity. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Strong desire and ability to work in a team environment. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Flexibility and coachability in the context of organizational growth and process change and development. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Demonstrated ability to prioritize workload in a fast-paced environment, with proven organization and time management skills.</span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">Education & Experience Required</span></strong></p> <ul style="margin-bottom:0.0in;margin-top:0.0px"> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Associates Degree or Nursing Diploma</span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">3 or more years of experience in the field of health care working directly with patients.</span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">2 or more years of experience in the absence management industry managing disability claims. </span></li> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Active, unrestricted medical license in the state of residence.</span></li> </ul> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><em><span style="font-size:12.0pt;font-family:Arial, sans-serif">Or an equivalent combination of education and experience</span></em></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><em><span style="font-size:12.0pt;font-family:Arial, sans-serif"> </span></em></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">Education & Experience Preferred</span></strong></p> <ul style="margin-bottom:0.0in;margin-top:0.0px"> <li style="margin:0.0in 0.0in 0.0in 0.0px;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Bachelor's Degree In healthcare or related field.</span></li> </ul> <p style="margin:0.0in 0.0in 0.0in 0.5in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">Travel</span></strong></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">Less than or equal to 10%</span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">Principal Duties & Responsibilities</span></strong></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Serves as a clinical subject matter expert to disability case managers and provides well-reasoned and timely clinical analyses related to functional impairment. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Reviews and evaluates disability claims to determine level of functioning based on knowledge of co-morbid health conditions. • Investigates and resolves inconsistencies in the level of functioning. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Through a clinical advocacy approach, the clinician partners with case managers on return-towork plans via contacts with treating providers and employees when applicable. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Assists in investigating and resolving inconsistencies in the level of employee functionality related to treating provider opinions, and projections of incapacity and impairment. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• 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 medial reviews, internal impairment guides, claim discussion meetings, reviews). </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Acts as a clinical consultant and resource to the Appeals department when applicable and attends meetings as needed. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Provides continuing education for case management staff via mini-clinical lectures, and assists in the development of clinical tools, guides, training, templates, processes, and protocols. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Attends and/or presents clinical lectures designed to educate claims staff as requested. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Facilitates referrals to ancillary internal and external services, e.g. EAP, disease management programs, advocacy, care managers, etc. as applicable. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Identifies barriers in returning to work, to include identifying and prompting optimal health care to facilitate an appropriate and timely return-to-work plan and strategy. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Communicates effectively with case managers, employers, employees, and health care providers. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Anticipates, recognizes, and responds timely to needs of customers to ensure customer satisfaction. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Supports implementation of customer initiatives to drive best outcomes. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Reviews assigned customer cases, prioritizes workload, and interprets established processes and guides to resolve customer issues. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Provides status updates to case managers to ensure clear communications and transparency. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Resolves technical problems by referring to policies, procedures, and specifications, to ensure accuracy and operational consistency. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Collects data and prepares clinical reviews, including commentary and an analysis to facilitate decision-making. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Inputs relevant data into established systems accurately to allow for data analysis. </span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><span style="font-size:12.0pt;font-family:Arial, sans-serif">• Performs other related duties as required.</span></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><strong><span style="font-size:12.0pt;font-family:Arial, sans-serif">Total Rewards</span></strong></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><em><span style="font-size:12.0pt;font-family:Arial, sans-serif;color:black">The salary range for this job is $80,000 to $95,000. This range is specific to the job and salary offers consider a wide range of factors that are considered in making compensation decisions, including, but not limited to: education, experience, licensure, certifications, geographic location, and peer compensation. The range has been created in good faith based on information known to Aflac at the time of the posting. </span></em></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><em><span style="font-size:12.0pt;font-family:Arial, sans-serif;color:black"> </span></em></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><em><span style="font-size:12.0pt;font-family:Arial, sans-serif;color:black">At Aflac, it is not typical for an individual to be hired at or near the top of the range for the role to allow for future and continued salary growth, and 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. </span></em></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><em><span style="font-size:12.0pt;font-family:Arial, sans-serif;color:black"> </span></em></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"><em><span style="font-size:12.0pt;font-family:Arial, sans-serif;color:black">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.</span></em></p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> <p style="margin:0.0in;font-size:10.0pt;font-family:'Times New Roman', serif"> </p> </span>