Job Location: United States: Oriskany: New York, Tampa, Florida, Cary, NC

Role Value Proposition:

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 plan.

Key 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 plan.

· 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

Essential Business Experience and Technical Skills:

Required

• New Hires should live within a commutable distance of Oriskany, NY, Tampa, FL, or Cary, NC

• Moderate knowledge of computer systems.

• Strong written/verbal communication.

• Current RN licensure

• 4+ years of experience as an RN with adult patients

Preferred

· BSN

• Bilingual a plus

· 7+ years Disability claims and/or clinical experience.

· Disability claims experience

· Preferred designations CCM (certified case management) and/or CDMS (certified disability management specialist).

· Possess strong knowledge of medical conditions, symptoms, and terminology.

MetLife maintains a drug-free workplace.

At MetLife, we’re leading the global transformation of an industry we’ve long defined. United in purpose, diverse in perspective, we’re dedicated to making a difference in the lives of our customers.