Job Description

Must be within a commutable distance of the Oriskany, NY, Tampa, FL, Cary, NC, Aurora, IL, Bloomfield, CT, office location

In office once a month for meetings

Training 8 10 weeks, M-F virtual (8 4pm) EST

Shift: 8 hour day + 1/2 hour lunch. Start time flexible from 7 9am EST.

Start Date: 03/2/2026

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:

• Bachelors in Nursing
• 4+ years clinical experience.
• Current RN licensure.

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).
• Possess strong knowledge of medical conditions, symptoms and terminology.

Equal Employment Opportunity/Disability/Veterans

If you need an accommodation due to a disability, please email us at accommodations@metlife.com. 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.

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