StateJobsNY

NY HELPNo

AgencyWorkers' Compensation Board

TitleMedical Care Representative, #3074

Occupational CategoryHealth Care, Human/Social Services

Salary Grade19

Bargaining UnitPS&T - Professional, Scientific, and Technical (PEF)

Salary RangeFrom $55126 to $70013 Annually

Employment Type Full-Time

Appointment Type Contingent Permanent

Jurisdictional Class Competitive Class

Travel Percentage 10%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 9 AM

To 5 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? No

County Albany

Street Address Medical Director's Office

Riverview Center, 150 Broadway, Suite #195

City Menands

StateNY

Zip Code12041

Minimum Qualifications List Qualifications: Candidates must be reachable on the Medical Care Representative eligible list.

Transfer Qualifications: Candidates must have permanently served at least one year as a Medical Care Representative to be eligible for transfer in accordance with Section 70.1 of the Civil Service Law.
*THERE ARE NO ADDITIONAL CIVIL SERVICE TITLES THAT HAVE BEEN DESIGNATED TRANSFER ELIGIBLE.

Duties Description Under the guidance of the Medical Director and Principal Medical Care Representative (SG-25), with direct supervision by the Supervising Medical Care Representative (SG-23) the Medical Care Representative (SG-19) is mainly responsible for review of treatment requests to determine medical necessity of treatments requested for workers’ compensation claimants and answering calls form external stakeholders. The incumbent must be knowledgeable of New York State (NYS) Workers’ Compensation law, rules and regulations and appropriately represent the Workers’ Compensation Board while interacting with healthcare providers, payers, attorneys and claimants. In addition, the incumbent will be required to have excellent organizational, written and verbal skills. Specific duties include but are not limited to the following: reviewing and performing a comprehensive medical review of treatment requests using submitted medical evidence, peer reviewed articles and citations, evidence based Medical Treatment Guidelines, clinical experience and collaborating with peers; presenting treatment recommendations to the Medical Director including rationale and supporting arguments for the recommendation; creating and issuing Notice of Resolutions; making recommendations to the Medical Director regarding the updating of Medical Treatment Guidelines based on inquires received from phone calls, emails and correspondence; assist in the review and correct application of newly released and/or updated Medical Treatment Guidelines as well as educating external stakeholders on any updates; understanding and applying current Medical Care Fee schedules as needed; and collaborating on special assignments as needed.

Some positions may require additional credentials or a background check to verify your identity.

Name Cassandra Cade

Telephone

Fax 518/486-6364

Email Address HRM@WCB.ny.gov

Address

Street Human Resources Office - Room 133

328 State Street

City Schenectady

State NY

Zip Code 12305

Notes on ApplyingQualified candidates should send a letter of interest and resume which lists your actual Civil Service title, salary grade and specific verifiable information as to how you meet the minimum qualifications to be eligible to apply for this position. Please send your application to HRM@WCB.ny.gov (email applications are preferred). It is important that you reference the WCB Item #3074 in the subject line of your email to ensure receipt of your application. (Please do not reference the Vacancy ID No.)