Job Description

CountryIndiaWorking ScheduleFull-TimeWork ArrangementHybridRelocation Assistance AvailableNoPosted Date05-Aug-2024Job ID3816Description and RequirementsPosition SummaryAt 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

• \xc2\xb7 Provides professional medical, technical, consulting advice, and recommendations in support of claims

evaluation, investigation, and assessment for various claims-related departments, while managing assignedcaseload of complex case applying specialized training and knowledge to the assessment of cases and actingas a resource on clinical and technical issues.

• \xc2\xb7 Conducts complex research, review and analysis of medical records, treatment plans and claim information.

• \xc2\xb7 Provides recommendations regarding claimants\' current potential functional abilities and develops

goal-focused return-to-work plans.

• \xc2\xb7 Assess training needs and creates, authors, and presents medical training to claim and business partner

associates.

• \xc2\xb7 Engages claimants, healthcare providers, employers, and customers to ensure strict adherence in determining

functional abilities.

• \xc2\xb7 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.

• \xc2\xb7 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 requiredEducation, Technical Skills & Other Critical RequirementEducationBachelor\'s degree (Medical) or diploma with a minimum of 15 years of education.Experience(In Years)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/other 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.

Other Critical Requirements Like Voice/ Non-Voice for Insurance OpsBlendedComplexity Scale: 9/T5C5

MetLife