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City/Cities
Noida
Country
India
Working Schedule
Full-Time
Work Arrangement
Hybrid
Relocation Assistance Available
No
Posted Date
30-Aug-2024
Job ID
3566

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).