Clinical Support Consultant

Job Location:Virtual :New Hires Should live within a commutable distance of the Oriskany, NY, Tampa FL Aurora IL Bloomfield CT office

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.

Duties and key responsibilities:

Key Responsibilities:

• Virtual roles predominately work from a home office with periodic visits to the assigned GCSO office as needed for team events, meetings, training, business continuity, etc.

• Assesses training needs and creates, authors, and presents medical training to claim and business partner associates.
• Manages assigned caseload of complex cases, applies specialized training/knowledge to assess cases, acts as resource on clinical/technical issues, and performs analysis as part of the audit process.
• Conducts complex research and analysis of medical and claims information.
• Provides recommendations regarding claimants’ current potential functional abilities and develops goal-focused return-to-work plan.
• Contacts 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.
• Participates and presents return to work ready claims on Lost Time Intervention Team meetings with the customer and their medical vendor.
• Performs other related duties as assigned or required.

Essential Business Experience and Technical Skills:

Required

• Strong knowledge of medical conditions, symptoms, and terminology.
• Moderate knowledge of computer systems.
• Strong written/verbal communication.
• Strong relationship building and management
• Bachelors in Nursing
• Current RN licensure
• 2 years of experience as an RN

Preferred

• Disability claims experience

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.”

MetLife:

MetLife, through its subsidiaries and affiliates, is one of the world’s leading financial services companies, providing insurance, annuities, employee benefits and asset management to help its individual and institutional customers navigate their changing world. Founded in 1868, MetLife has operations in more than 40 countries and holds leading market positions in the United States, Japan, Latin America, Asia, Europe and the Middle East.

We are one of the largest institutional investors in the U.S. with $642.4 billion of total assets under management as of March 31, 2021. We are ranked #46 on the Fortune 500 list for 2021. In 2020, we were named to the Dow Jones Sustainability Index (DJSI) for the fifth year in a row. DJSI is a global index to track the leading sustainability-driven companies. We are proud to have been named to Fortune magazine's 2021 list of the "World's Most Admired Companies."

MetLife is committed to building a purpose-driven and inclusive culture that energizes our people. Our employees work every day to help build a more confident future for people around the world.

We want to make it simple for all interested and qualified candidates to apply for employment opportunities with MetLife. For further information about how to request a reasonable accommodation, please click on the Disability Accommodations link below.

MetLife is a proud Equal Employment Opportunity and Affirmative Action employer dedicated to attracting, retaining, and developing a diverse and inclusive workforce. All qualified applicants will receive consideration for employment at MetLife without regards to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, age, disability, national origin, marital or domestic/civil partnership status, genetic information, citizenship status, uniformed service member or veteran status, or any other characteristic protected by law.

MetLife maintains a drug-free workplace.

Requisition #: 127362