Review Vacancy
Date Posted: 03/22/17
Applications Due: 04/06/17
Vacancy ID: 37780
Position Information
NY HELPNo
AgencyInsurance Fund, State
TitleMedical Care Representative
Occupational CategoryHealth Care, Human/Social Services
Salary Grade19
Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)
Salary RangeFrom $57354 to $72841 Annually
Employment Type Full-Time
Appointment Type Permanent
Jurisdictional Class Competitive Class
Travel Percentage 20%
Schedule
Workweek Mon-Fri
Hours Per Week 37.50
Workday
From 9 AM
To 5 PM
Flextime allowed? Yes
Mandatory overtime? No
Compressed workweek allowed? Yes
Telecommuting allowed? No
Location
County Broome
Street Address 2001 Perimeter Road East
City Endicott
StateNY
Zip Code13760
Job Specifics
Minimum Qualifications Reachable on current open competitive Civil Service list for this title or one year of permanent, competitive class service as a Medical Care Representative.
Duties Description Medical Care Representatives (MCRs) at the New York State Insurance Fund coordinate global case management of high-cost complex cases and are an extensive resource/mentor of the NYS Workers’ Compensation Board Medical Treatment Guidelines for Claims Service Managers and other Claims staff. The incumbent will be extensively involved in assessing and monitoring opioid usage as well as instrumental in the preparation for litigation in chronic pain management and other medically-related issues. Duties will include, but are not limited to: Manage daily medication prior authorizations through our Pharmacy Billing Manager intermediary and perform weekly audits on medication usage. Provide in-patient and out-patient, home care, long-term care management of the injured worker. Perform Utilization Review of DME, DRG, EAPG and complex bills and payments. Communicate with medical providers and vendors regarding medical aspects of claims. Utilize multiple complex computer programs and documentation to complete duties as necessary. The ideal candidate should have excellent time management and teamwork skills, as well as the ability to work independently.
Additional Comments To apply, please send your resume and cover letter to hr@nysif.com. Please include the Vacancy ID number in your subject line.
Some positions may require additional credentials or a background check to verify your identity.
Contact Information
Name Lynn Hausman
Telephone
Fax 518-437-1618
Email Address hr@nysif.com
Address
Street 15 Computer Drive West
City Albany
State NY
Zip Code 12205
Notes on ApplyingPlease include the position title and Vacancy ID number on your cover letter. Candidates should email a resume and cover letter hr@nysif.com. Candidates may also mail their applications to 15 Computer Drive West, Albany, NY 12205 or fax to 518-437-1618.
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