Clinical Support Consultant - RN - 12/2/24 - 4368

Description and Requirements
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.
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.
• 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.

Benefits We Offer
Our U.S. benefits address holistic well-being with programs for physical and mental health, financial wellness, and support for families. We offer a comprehensive health plan that includes medical/prescription drug and vision, dental insurance, and no-cost short- and long-term disability. We also provide company-paid life insurance and legal services, a retirement pension funded entirely by MetLife and 401(k) with employer matching, group discounts on voluntary insurance products including auto and home, pet, critical illness, hospital indemnity, and accident insurance, as well as Employee Assistance Program (EAP) and digital mental health programs, parental leave, volunteer time off, tuition assistance and much more!
About MetLife
Recognized on Fortune magazine's list of the 2024 "World's Most Admired Companies" as well as the 2024 Fortune 100 Best Companies to Work For ®, 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 individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.
Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by empathy, we're inspired to transform the next century in financial services. At MetLife, it's #AllTogetherPossible . Join us!
Equal Employment Opportunity/Disability/Veterans
If you need an accommodation due to a disability, please email us at [email protected]. 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.