Job Description

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: 05/18/2026

In office once a month for team meetings

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 cases 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

• Moderate knowledge of computer systems.

• Strong written/verbal communication.

• Current RN licensure

• Associate's degree, or BSN

• 4+ years of experience as an RN

Preferred

• BSN

• 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 [email protected]. 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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