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Clinical Manager - Quality Assurance

Date Posted: Jul 20, 2019

Location: Cary, NC, US, 27511

Company: MetLife

Job Location : United States : Cary : North Carolina

 

Role Value Proposition: 

Global Technology & Operations (GTO) includes over 17,000 associates across 42 countries Service our customers in operations and global customer call centers where we deliver global support services, including global real estate, global corporate security, and global innovation.  This role, for a Clinical Manager – Quality Assurance, will conduct quality process inspections, reviews and assessments for processes and transactions; collecting, analyzing and using quality control to diagnose root causes and create and recommend corrective action plans; and identifying trends and improvement opportunities.

   

Key Responsibilities: 

  • Direct and overall responsibility for the design or improvement and maintenance of a quality assurance process.
  • This person will lead a team of Quality Auditors with professional skills and designations within nursing, behavioral health and vocational rehabilitation fields.
  • The team is responsible for administering all aspects of the claims quality program with respect to the Return to Health (formerly known as Clinical) organization.
  • In addition to team management, this person will also conduct audits, write reports and facilitate and continuous improvement cycle within Claims and Return to Health teams.
  • The right candidate has a BS in nursing and experience with insurance operations.

 

Essential Business Experience and Technical Skills:

Required:

  • Bachelor’s degree
  • Licensure in RN, LPC, LCSW or VRC / CRC
  • 10+ yrs. related experience
  • 5+ yrs leading projects

 

Preferred:

  • Advanced degree
  • 12+ yrs. related experience
  • 7+ yrs leading projects
  • Expert knowledge of the financial services industry and the operational transactions and processes supported.
  • Expert knowledge of statistical analysis techniques and methodologies.
  • Expert analysis and problem solving. Expert communication skills. 

  

Travel

Up to 25%

  

“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 is a proud equal opportunity/affirmative action employer committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce. It is MetLife's policy to ensure equal employment opportunity without discrimination or harassment based on 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.

For immediate consideration, click the Apply Now button. You will be directed to complete an on-line profile. Upon completion, you will receive an automated confirmation email verifying you have successfully applied to the job.

Requisition #: 108987 


Nearest Major Market: Raleigh