Disability Reviewer II

University of Massachusetts Medical School•Westborough, MA

7d•$68,000 - $80,000

About The Position

Under the general direction of the Program Manager or designee, the Disability Reviewer II leads and performs varied work for multiple state disability determination agencies, public retirement systems, and assessments or reviews for the Office of Clinical Affairs and other UMass Chan Medical School entities or state agencies. Reviews may include medical and psychiatric evidence, vocational profiles, state statutes and guidelines, and other relevant evidence to determine whether an individual meets standards under applicable state and federal laws and regulations. Determinations may result in the awarding or denial of benefits to an applicant or retiree.

Requirements

Registered Professional Nurse with a current unrestricted license and three years of relevant experience; or a master's-prepared, licensed or certified vocational rehabilitation counselor or other licensed or certified allied health professional with two years of relevant experience in acute medicine, long-term care, mental health, developmental disabilities, substance abuse, rehabilitation, vocational counseling, or equivalent.
Ability to work in a team environment, interpret state and federal laws and regulations, and meet performance deadlines in a dynamic environment.
Excellent oral and written communication skills.
Demonstrated experience using computer-based tools, including electronic mail, word processing, and database products.
Ability to travel off site as needed.

Responsibilities

Serve as an emergent intervention agent when encountering a client-in-crisis situation.
Contact providers, state agency offices, case managers, and clients to obtain information and records for comprehensive case reviews and final determinations.
Participate in the appeals process for denied claims, communicating with state agencies, applicants, and other parties as needed.
Manage a caseload of disability applicants seeking assistance through state or private benefit programs.
Contribute as an active member of a multidisciplinary 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 and performance improvement initiatives, applying quality improvement in daily operations.
Maintain the confidentiality of business documents and correspondence in accordance with UMass Chan/ForHealth Consulting procedures and HIPAA regulations.
Follow established procedural standards and accepted best practices.
Maintain positive working relationships with applicants, providers, state agencies, and other DES clients.
Document relevant information in data system applications.
Comply with health, safety, and program regulations and requirements.
Perform other duties as required.