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Disability Reviewer II

2 months ago

Shrewsbury Massachusetts, United States University of Massachusetts Medical School Full time

Job Summary:

The University of Massachusetts Medical School seeks a skilled Disability Reviewer II to join our team. As a Disability Reviewer II, you will play a critical role in leading and performing diverse work for multiple State disability determination agencies, Public Retirement Systems, and assessments/reviews for the Office of Clinical Affairs and other UMass Chan Medical School entities or State agencies.

Key Responsibilities:

  • Assume responsibility for being an emergent intervention agent when confronted with a client-in-a-crisis situation.
  • Contact providers, state agency offices, case managers, and clients to obtain information and records needed to conduct a comprehensive review of the case and final determination.
  • Participate in the appeals process for denied claims through communication with state agencies, applicants, and other parties as necessary.
  • Efficiently manage a caseload of disability applicants (clients) applying for assistance as a disabled individual through state or private benefit programs.
  • Contribute as an active member of a multi-disciplinary team that includes nurses, vocational rehabilitation counselors, physician advisors, and other allied health professionals.
  • Participate in and serve as a resource to quality improvement committees, performance improvement initiatives, and demonstrate the use of quality improvement in daily operations.
  • Maintain the confidentiality of all business documents and correspondence per UMass Chan/ForHealth Consulting procedures and HIPAA regulations.
  • Follow all established Procedural Standards and accepted best practices.
  • Maintain positive working relationships with applicants, providers, state agencies, and other DES clients.
  • Document all relevant information into data system applications.
  • Comply with all health, safety, and program regulations and requirements.
  • Perform other duties as required.

Qualifications:

  • RN - Registered Professional Nurse with current unrestricted license with three years of relevant experience.
  • OR
  • Masters prepared licensed or certified vocational rehabilitation counselor or other licensed or certified Allied Health professional with 2 years of relevant experience in one or more of the following areas; acute medicine, long term care, mental health, developmental disabilities, substance abuse, rehabilitation, and/or vocational counseling or equivalent.
  • Ability to work in a team environment, interpret state and federal laws and regulations, meet performance deadlines in a dynamic environment.
  • Excellent oral and written communications skills.
  • Demonstrated experience using computer-based tools including electronic mail, word processing, and database products.
  • Ability to travel off site as needed.