Disability Review Analyst at Chenega Corporation

Overview

C2 ALASKA, LLC

Telework

THIS POSITION IS CONTINGENT UPON BID AWARD

The Disability Review Analyst is responsible for conducting reviews of disability claims competed by Medical and Psychological consultants and assisting with the initial onboarding and training of medical and psychological consultants. The Analyst identifies deficiencies in case work, documents the findings, cites to relevant policy, and provides next step actions to bring the claim into compliance. The Analyst will be responsible for training medical and psychological consultants on how to complete disability claims in accordance with SSA policy

Responsibilities

• Keep current on SSA policy and medical research for successful reviews of medical assessments.
• Attend required meetings, briefings, and workgroups necessary to perform independent case reviews (e.g., policy updates, procedural changes) or to discuss administrative issues related to the contract.
• Respond to all communications including instant message or email.
• Participate in presentations, as needed.
• Provide consultation and expertise on policy development issues including written and/or oral summarizations.
• Facilitate, conduct, monitor, and/or participate in training activities with MCs.
• Provide insight and guidance to consultants for ongoing training and offer consultative support for initial training and orientation.
• Review disability claims to determine the adequacy of case development, the documentation of determinations, and the accuracy of decisions based upon the facts and program guidelines to monitor the quality of the adjudication process.
• Prepare written reports identifying and describing findings which include decisional and significant technical deficiencies in the adjudication process and the resulting reports for the purpose of providing direction to adjudicators to make corrective action in the case decision.
• Review corrective actions and final case decision of returned cases upon completion of remedial action to assure accurate completion of case adjudication.
• Identify substantive and procedural issues medical/psychological consultant working relationships and information exchanges; analyzes delays in operational workflow and identifies training needs and problems.
• Participate in special studies and case reviews, reports findings respective Quality Assurance Manager for administrative action.
• Assist with program evaluation and identifies weaknesses and deficiencies in the electronic case processing systems, quality and integration of medical consultant assessments, all support functions, and basic claim adjudication processes.
• Assist in providing training to adjudicators and consultants in deficiency areas (e.g., claim processing operations) to correct problems.
• Review claims returned by federal components (Office of Disability Operations/Disability Quality Board) noting trends in returns; compares these returns to deficiencies noted internally in order to determine if Quality Assurance is consistent with review and return policy.
• May assist the Quality Assurance Manager in preparing monthly and quarterly reports of Quality Assurance findings.
• Other duties as assigned.

Qualifications

• High School Diploma or GED
• Minimum three (3) years of experience within the last seven (7) years evaluating disability claims within an Internal Quality Assurance, Office of Quality Review or Disability Quality Board at the State or Federal SSA level with the SSA. Minimum six (6) months experience in disability adjudication appeal and review process.
• Minimum six (6) months experience in interpreting Social Security Administration laws, rules, regulations, standards, policies, and procedures.
• Minimum six (6) months experience in program evaluation which includes evaluating programs and services to identify problems, determine compliance and evaluate the effectiveness and efficiency to ensure program goals and overall objectives are met.
• Minimum six (6) months experience in recommending alternatives, improvements, courses of action and other changes based on findings.
• Minimum six (6) months experience in narrative report writing.

Knowledge, Skills and Abilities

• Knowledge of the disability determination process
• Experience in training consultants (medical and psychological) or Disability Examiners in completing SSA claims, Preferred
• Experience working in the disability policy community, either from a medical or legal perspective.
• Ability to organize and effectively administer training covering complex and technical content to professionals.
• Ability to read, write, and speak English well enough to effectively communicate with all parties and other health care providers.
• Knowledge of the required education, training, experience, and documented current competence in the required specialty position description.
• Possess sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to a variety of patients from diverse backgrounds.
• Possess exceptional organizational and time management skills with the ability to navigate multiple duties/responsibilities.
• Ability to write in a clear, concise, grammatically correct manner.
• Knowledge and excellent computer skills including the use of computer software applications for drafting documents, data management, and tracking. This includes competency with Microsoft Office (Word, Excel, Outlook, PowerPoint).

Physical Demands (The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

• While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee may use repeated motions that include the arms, wrists, hands and/or fingers. The employee is occasionally required to walk, stand, climb, balance, stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.

Teleworking Permitted?

Teleworking Details

Estimated Salary/Wage