Unit Manager - Clinical Support

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.

To apply, Call HR Nikita Grover at 8800307658

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

Education, Technical Skills & Other Critical Requirement

• Bachelors degree (Medical) or diploma with a minimum of 15 years of education.

Experience

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).