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Clinical Support Consultant

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Date Posted: Jun 23, 2022

Location(s): Tampa, FL, US, 33647 Dayton, OH, US, 45448 Oriskany, NY, US, 13424 PORTLAND, OR, US, 97221 New York, NY, US, 10036 Cary, NC, US, 27513 Bloomfield, CT, US, 6002 Chattanooga, TN, US, 37412 Omaha, NE, US, 68114 Portland, ME, US, 4101 Phoenix, AZ, US, 85085 Warwick, RI, US, 2886 Troy, MI, US, 48083 Bridgewater, NJ, US, 8807 Aurora, IL, US, 60504 Marlborough, MA, US, 1752

Company: MetLife

Job Location:  Virtual within a commutable distance of Tampa FL,  Portland OR,  Bloomfield CT,  Phoenix AZ,  New York NY,  Cary NC,  Portland ME,  Marlborough MA,  Bridgewater NJ,  Warwick RI,  Aurora IL,  Oriskany NY,  Omaha NE,  Dayton OH,  Troy MI,  Chattanooga, TN.

 

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 of the Clinical STD/FMLA Support Consultant will provide exemplary customer service by processing Short Term Disability claims in a timely and accurate manner as well as managing FML claims that will run concurrent with the STD claims for a Large Customer.

 

 Key Responsibilities:  

  • Virtual roles predominately work from a home office with periodic visits to the assigned GCSO office as needed for team events, meetings, training, business continuity, etc.
  • Independently assess, analyze and render appropriate claim decisions pursuant to certificates on all claims.
  • Compare duration control guidelines and clarifies functional inconsistencies.
  • Develop goal-focused return-to-work plans and or barriers for return-to-work. Partner with Return –to-Work Coordinator on account to ensure successful RTW.
  • Clarify functional capacity through independent problem solving measures and discretion (gathering medical, vocational, and other information, efficient use of resources, and action planning) sufficient to determine initial and ongoing liability by adhering to federal and state law to maintain appropriate and timely claim outcomes.
  • Communicate clearly and concisely to influence return to work, discuss terms of the certificate, and the basis for payment/non-payment.
  • Communicate with a variety of constituents (for example, claimants, doctors, nurses, employers, and attorneys) to gather information relevant to assessing, analyzing and rendering decisions based on the provisions of the policy and their own discretion, with limited guidance by supervisory personnel.
  • Prepare written summary for Quarterly customer meetings to review cases that are identified via report parameters, you or the customer to discuss and participate in quarterly meetings with the Vocational resource and Account team member.
  • Participate in claim review meetings as requested by the customer.
  • Utilize tools independently and accurately to identify work to be completed across the entire claim block, prioritize work, determine if/when to involve specialty resources such as Psychiatric Clinical Specialist, Medical Director or other clinical staff to obtain additional information on a claim by articulating and documenting their rationale for claim direction, possessing the autonomy to take steps outside of CMG guidelines to the extent supported by documented rationale and the facts of the claim file.
  • As the sole owner of the claim, determine return to work potential and strategy, identify a likely claim progression based on the facts of the claim and take action on their own assessment of the claim and provide mentoring and/or coaching to less experienced team membersPerforms other duties as assigned or required.
  • Manages assigned caseload of short-term disability (STD) and/or Family & Medical Leave Act (FMLA) claims; applies specialized clinical training/knowledge to the assessment of cases.

 

Essential Business Experience and Technical Skills:

 Required:

  • New hires should live a commutable distance from the site the role is posted in.
  • 2+ years of Clinical Experienced required
  • Nursing Degree with RN license required
  • Strong communication skills, both written and oral.
  • Demonstrated critical thinking in activities requiring analysis, investigation, and/or planning.
  • Strong customer satisfaction focus.

 

Preferred:

  • BSN Preferred
  • Disability Claims Experience

 

Business Category

Operations - Claims

 

Travel

Less than 10%

 

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.

 

 

Requisition #: 126724

 


Nearest Major Market: Tampa