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Sr. Disability Clinical Specialist

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Valero

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Location:
United States , San Antonio

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Category:
Human Resources

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

Responsible for reviewing analyzing, and interpreting medical documentation and determining eligibility for Short-Term Disability (STD) and Family and Medical Leave Act (FMLA) claims. This role acts as a clinical resource for HR and claim professionals, evaluating medical information to clarify diagnoses, validate restrictions and limitations, and estimate recovery duration. This role ensures compliance with all applicable federal and state leave laws while providing compassionate and consistent case management. This role collaborates closely with employees, healthcare providers, and internal teams to support optimal claim outcomes and timely return-to-work coordination.

Job Responsibility:

  • Reviews and analyzes medical documentation submitted for assigned STD and FMLA claims
  • Determines eligibility and benefit duration in accordance with company policies and applicable legal requirements
  • Act as a clinical resource to HR and claim professionals, providing guidance on medical management and claim decisions
  • Recommend specific medical information needed to evaluate ongoing impairment and facilitate optimal claim management
  • Make appropriate referrals to internal and external clinical resources (e.g., IME, FCE, peer reviews)
  • Communicates clearly with employees, healthcare providers, and internal partners throughout the claim process
  • Coordinates with third-party medical review vendors for complex or extended claims
  • Evaluates claims for potential work-related illnesses or injuries and initiate appropriate follow-up actions with HR, Safety, Claims Management, or Legal
  • Provides guidance and explanations of medical review protocols and claim decisions to employees and HR staff as needed
  • Collaborates with HR, healthcare providers and medical teams to facilitate return-to-work plans
  • Maintain accurate and timely documentation of all claim activity in the leave management system
  • Assists in communicating and interpreting leave and disability policies, providing training and support to HR/medical staff as needed

Requirements:

  • High School diploma or GED required
  • Active LVN or RN license required
  • 5 years of experience in clinical nursing or occupational health required
  • Able and willing to work on-site, in-person at the Valero San Antonio location, required

Nice to have:

  • Bachelor’s degree preferred
  • Experience working as a disability case examiner in a corporate environment preferred
  • Previous insurance industry experience and proficiency with Disability Management (STD/LTD), Workers’ Compensation, Utilization Review, and/or nurse case management preferred
What we offer:
  • Competitive Pay and Annual Bonus Program
  • 100% match on 401(K) up to 7%, with immediate vesting
  • Company-sponsored Pension Plan
  • Comprehensive Healthcare and Wellness Programs
  • Onsite Daycare Center
  • Onsite Employee and Family Wellness Centers (Physician & Pediatrician)
  • Onsite Pharmacy
  • State-of-the-art 24-hour Fitness Center free for employees and spouses with access to Tennis and Basketball Facilities
  • Onsite cafeteria open for breakfast and lunch
  • Sprawling campus with walking paths and access to biking trails

Additional Information:

Job Posted:
January 06, 2026

Employment Type:
Fulltime
Work Type:
On-site work
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