Job Description

Country
India
Working Schedule
Full-Time
Work Arrangement
Hybrid
Relocation Assistance Available
No
Posted Date
18-Jul-2024
Job ID
3567
### 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. Skills 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).



Technical Skills:

• Computer navigation skills
• Excellent Keyboarding and data entry speed
• Knowledge about US Culture is preferred.
• Excellent verbal/written communication skills - should be able to read, interpret business documents.
• Excellent analytical and interpersonal skills
• Data gathering ability/ Eye for detail.
• Ability to comprehend and apply varied rules to multiple policies.
• Teamwork/ Managing Self / Adaptability
• Ability to work successfully and perform detail-oriented work in production driven environment.
• Excellent organizational skills
• Proven ability to meet quality and time standards.
• Ability to work on routine/standardized transactions.
• Possess strong knowledge of medical conditions, symptoms, and terminology.