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Behav Health Clinician Rev

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Aflac

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Location:
United States

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Category:
Insurance

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Contract Type:
Not provided

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Salary:

75000.00 - 90000.00 USD / Year
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Job Description:

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. Our business is about being there for people in need.

Job Responsibility:

  • Serves as clinical co-manager on behavioral health claims from inception of STD claims
  • Reviews and evaluates disability claims to determine level of functioning
  • Investigates and resolves inconsistencies in the level of cognitive, emotional, or behavioral functioning
  • Coordinates a strategy to determine true level of functional capacity
  • Reviews claims from a behavioral health perspective to determine if clinical evidence supports preclusion from work
  • Documents impairment, functional status, and assessment
  • Acts as behavioral health consultant to the appeals business unit
  • Acts as resource for claims and clinical staff when handling claimants noted to be threatening harm to themselves or others
  • Facilitates referrals to collateral internal and external services
  • Monitors response to care and advocates for optimal care
  • Coordinates and monitors quality of behavioral health IME's
  • Coordinates internal physician consultant referrals
  • Identifies barriers for employees to return-to-work
  • Communicates effectively with case managers, employers, employees, and health care providers
  • Strategizes with claimant, treating providers, and employer on possible accommodations
  • Manages daily relations with assigned accounts and key contacts
  • Per account requirements and upper management request, visits clients
  • Attends and/or presents clinical lectures designed to educate claim staff
  • Anticipates, recognizes, and responds timely to needs of customers
  • Supports implementation of customer initiatives
  • Reviews assigned customer cases, prioritizes workload, and interprets established policies
  • Provides status updates on co-management plans
  • Resolves technical problems by referring to policies, procedures, and specifications
  • Collects data and prepares clinical reviews
  • Provides detailed procedural advice to internal clients
  • Inputs relevant data into established systems accurately
  • Performs additional job duties as needed

Requirements:

  • Master's Degree In Behavioral Health area or related field, e.g., MSW, MA or MS in counseling
  • A minimum of 3 years of experience in the field of behavioral health working with behavioral health patients
  • Active clinical license e.g., LCSW, LMHC, LPC, RN etc. or equivalent clinical license
  • Psychiatric experience/knowledge
  • Solid investigative and analytical skills
  • Solid customer service skills
  • Solid written and oral communication skills
  • Solid organizational and time management skills
  • Ability to analyze behavioral health records in the context of functional capacity
  • Maintain active licensing and profession credentials as required

Nice to have:

  • 2 or more years of experience in disability management industry managing claims
  • CDMS or CCM designations
  • Utilization review experience and/or experience using specific behavioral health criteria or protocols
What we offer:
  • 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
  • opportunity to purchase company stock
  • 11 paid holidays
  • up to 20 days PTO
  • state-mandated sick leave
  • other leaves of absence

Additional Information:

Job Posted:
February 10, 2026

Expiration:
February 10, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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