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DDSSA PROFESSIONAL RELATIONS MGR
The DDSSA Professional Relations Manager is responsible for overseeing the activities of the medical relations department to ensure adherence to policies, procedures, and laws. This position is governed by state and federal laws and agency/institution policy.
Class Code:
G085C
Job Grade:
GS10
Special Job Requirements:
Occasional in and out-of-state travel is required.
Typical Functions:
Directs supervisors and support staff on changes in policies and procedures that affect the agency. Develops and implements operating policies and procedures. Manages recruitment and identification of Medical Consultants and health care providers to ensure providers are identified and recruited according to Social Security policy and procedures. Investigates and resolves complaints and prepares written responses explaining investigations. Monitors and analyzes statewide activities to identify trends, problems, and progress. Consults with in-house physicians regarding activities, policies, and problems with the medical community and recommends corrective actions to ensure medical community adheres to Social Security policies. Monitors negotiations and establishment of maximum allowable fees according to Medicare and Medicaid Agencies and ensures that consultative examination panelists adhere to regulations and are informed of changes in the State’s fee structure. Monitors budget funds for consultative examination cases by reviewing expenditures to ensure fund availability and that spending is within budgeted federal guidelines. Assists in formulating organizational policies by analyzing administrative procedures to devise efficient methods of accomplishing work. Performs other duties as assigned.
Knowledge, Abilities, and Skills:
Knowledge of the federal Social Security disability program. Knowledge of medical terminology. Knowledge of recruitment techniques. Knowledge of procedural codes to establish allowable fees. Ability to interpret federal rules and regulations relating to the federal Social Security disability program. Ability to prepare, present, and review oral and written information. Ability to analyze medical information ad prepare policies and procedures. Ability to plan, organize, and direct the work of others.
Minimum Qualifications:
The formal education equivalent of a bachelor’s degree in public administration, sociology, or a related field; plus three years of experience in administrative or professional Social Security disability adjudication, including one year in a supervisory or leadership capacity. Additional requirements determined by the agency for recruiting purposes require review and approval by the Office of Personnel Management. OTHER JOB RELATED EDUCATION AND/OR EXPERIENCE MAY BE SUBSTITUTED FOR ALL OR PART OF THESE BASIC REQUIREMENTS, EXCEPT FOR CERTIFICATION OR LICENSURE REQUIREMENTS, UPON APPROVAL OF THE QUALIFICATIONS REVIEW COMMITTEE.
Required Certificates:
None
Exempt:
E
