Key Responsibilities:
- Conducts medical reviews as needed to support the clinical assessment process and to make functional capacity outcome determinations for customers
- Reviews all applicable customer documentation, including the clinical assessment and all of its related documents
- The customer’s medical, mental health, and substance abuse assessments, treatments, and results (as provided by the customer and/or received from providers with customer consent)
- Prior WeCARE participation documents and updates, as applicable
- The determination about the need for reasonable accommodations and/or language services
- The results of the bio psychosocial assessment
- Noted discrepancies between the customer’s case record and documentation provided and the information they provided during the interview with the Qualified Health Professional (QHP)
- The results of any mental health and/or substance abuse screenings conducted by the QHP
- The results of the Social Security Administration five-step sequential evaluation
- The Functional Capacity Outcome (FCO) decision-support matrix, FCO determination, and rationale for the determination
- Completes standard medical review of systems
- Makes Functional Capacity Outcome (FCO) determinations for customers and provides written justification of the FCO
- May order or request additional assessments to support diagnoses and FCO determination
- Works collaboratively with service track staff to interpret any medical evaluation findings or documents that affect service planning and delivery
- May conduct training for other WeCARE team members in effective use of clinical assessment results in service planning
- Participates in team meetings to evaluate and improve clinical assessment processes, including providing input to the design of any review physician forms
- Participates in any required training related to the position and its responsibilities
- Understands and adheres to HRA policies and procedures and RWS standard operating procedures related to the clinical assessment process and physician review requirements, specifically
Qualifications:
- Must be a Physician, a New York State licensed doctor (Medical Doctor) with training in internal medicine, family practice, physical medicine and rehabilitation, or in other medical disciplines as designated by HRA
- Five years’ experience in conducting medical evaluations resulting in functional capacity outcome determinations
- Experience in a fast-paced, team environment that is performance driven
- Excellent organizational skills and strong attention to detail
- Experience with publicly-funded programs; TANF experience preferable
- Knowledge of laws and regulatory requirements related to program responsibilities
- Ability to use various electronic systems to carry out duties and responsibilities
- Bilingual or multilingual preferred
