MetLife

Locations: Oriskany, NY or Tampa, FL, Cary, NC,-primarily virtual role, with in-person collaboration days. Must be within a commutable distance of the Oriskany, NY,  Tampa, FL OR Cary, NC office location

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 

• Moderate knowledge of computer systems. Microsoft, Teams, OneNote
• Strong written/verbal communication. 
• Current RN licensure 
• 4+ years of experience as an RN

Preferred 

• BSN 
• 7+ years of 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.