Must be within a commutable distance of the Oriskany, NY, Tampa, FL, Cary, NC, Aurora, IL, Bloomfield, CT, office location
In office once a month for meetings
Training - 8 - 10 weeks, M-F virtual (8 - 4pm) EST
Shift: 8 hour day + 1/2 hour lunch. Start time flexible from 7 - 9am EST.
Start Date: 03/2/2026
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:
· Bachelors in Nursing
· 4+ years clinical experience.
· Current RN licensure.
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).
· Possess strong knowledge of medical conditions, symptoms and terminology.
Equal Employment Opportunity/Disability/Veterans
If you need an accommodation due to a disability, please email us at accommodations@metlife.com. This information will be held in confidence and used only to determine an appropriate accommodation for the application process.
MetLife maintains a drug-free workplace.
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