Description and Requirements
Position Summary:
At MetLife, we seek to make a meaningful impact in the lives of our customers and our communities. The Global Technology & Operations group (GTO) is a diverse team of engineers, developers, business analysts, claims analysts and project managers with the freedom to create innovative and solutions to address core business challenges with MetLife. This role will work with claimants, physicians, employers, and customers to ensure strict adherence in determining functional abilities. Provides recommendations regarding claimants' current/potential functional abilities and develops goal-focused return-to-work plans.
Job Responsibilities:
- Provides professional medical, technical, consulting advice, and recommendations in support of claims
evaluation, investigation, and assessment for various claims-related departments, while managing assigned
caseload of complex case applying specialized training and knowledge to the assessment of cases and acting
as a resource on clinical and technical issues.
- Conducts complex research, review and analysis of medical records, treatment plans and claim information.
- Provides recommendations regarding claimants' current potential functional abilities and develops
goal-focused return-to-work plans.
- Assess training needs and creates, authors, and presents medical training to claim and business partner
associates.
- Engages claimants, healthcare providers, employers, and customers to ensure strict adherence in determining
functional abilities.
- Engages claimants, health care providers and employers in return to work potential and planning while
coaching claim specialists on identifying and acting upon return-to-work potential.
- Creates effective requests for medical information which focus on clarifying medical restrictions and
limitations and their impact on work functionality. Performs other related duties as assigned or required
Required
- Current RN licensure
- 4+ years of experience as an RN with Clinical/Ops Experience
Preferred
- 7+ years Disability claims and/or clinical experience.
- Disability claims experience
Preferred designations CCM (certified case management) and/or CDMS (certified disability management specialist).
#BI-Hybrid
Top Skills
What We Do
Named one of Fortune’s “World’s Most Admired Companies,” MetLife is leading the global transformation of an industry we’ve defined for more than 150 years. At MetLife, every innovation and line of code is a lifeline for our customers and their families—from victims of natural disasters to people living with disabilities and beyond. With operations in more than 40 markets and leading positions across the globe, MetLife’s building a workforce of diverse and empowered voices that all belong. Join our remarkable journey—one in which you help write the next century of innovation in financial services—because with MetLife, making the world a better place is All Together Possible.
Why Work With Us
At MetLife, you’ll be working for a company whose purpose is to help customers throughout their life’s journey, and often in their most critical time of need. You’ll be a part of developing leading-edge platforms that will have a lasting impact on the lives and well-being of tens of millions of customers.
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