MetLife
Clinical Support Consultant - Nurse Consultant
This job is now closed
Job Description
- Req#: 133599
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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.
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Conducts complex research, review and analysis of medical records, treatment plans and claim information.
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Provides recommendations regarding claimants’ current potential functional abilities and develops goal-focused return-to-work plan.
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Assess training needs and creates, authors and presents medical training to claim and business partner associates.
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Engages claimants, healthcare providers, employers and customers to ensure strict adherence in determining functional abilities.
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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.
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Creates effective requests for medical information which focus on clarifying medical restrictions and limitations and their impact on work functionality.
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Performs other related duties as assigned or required
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Moderate knowledge of computer systems.
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Strong written/verbal communication.
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Current RN licensure
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4+ years of experience as an RN
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BSN
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7+ years Disability claims and/or clinical experience.
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Disability claims experience
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Preferred designations CCM (certified case management) and/or CDMS (certified disability management specialist).
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Possess strong knowledge of medical conditions, symptoms, and terminology.
Job Location: United States : Florida : Tampa
Alternate Job Location: United States : Florida : Tampa || United States : New York : Oriskany || United States : North Carolina : Cary
Work Arrangement: Virtual
Job Location: United States: Oriskany: New York, Tampa, Florida, Cary, North Carolina
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.
Key Responsibilities:
Essential Business Experience and Technical Skills:
Required
Preferred
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.
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About the company
MetLife, Inc. is the holding corporation for the Metropolitan Life Insurance Company, better known as MetLife, and its affiliates.