MetLife

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.