Review Physician


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



  • 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
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