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Review Vacancy

Date Posted 04/25/17

Applications Due05/10/17

Vacancy ID38568

AgencyInsurance Fund, State

TitleMedical Care Representative

Occupational CategoryHealth Care, Human/Social Services

Salary Grade19

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

Salary RangeFrom $58501 to $74301 Annually

Employment Type Full-Time

Appointment Type Permanent

Jurisdictional Class Competitive Class

Travel Percentage 20%

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

County Broome

Street Address 2001 Perimeter Road East

City Endicott

StateNY

Zip Code13760

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.

If you are not a current state employee or not on the current Civil Service list for this title, please visit the following link for instructions on how to apply for eligibility for this position:
https://www.cs.ny.gov/jobseeker/public/licensing.cfm. The Medical Care Representative exam announcement includes details on the minimum qualifications for list eligibility, as well as a link to the application form (NYS-APP), which can be found here:
https://www.cs.ny.gov/announ/applications.cfm.

Please also note the following important instructions included in the exam announcement when completing this application: "It is essential that you describe your education and experience as completely as possible on the NYS-APP Open Competitive Examination Application form. Ambiguity, vagueness, or omissions will not be decided in your favor. Do NOT send resumes. If you need more space, attach additional 8 1/2" x 11" sheets, following the same format used on the application form."

Please mail your completed application form to:
NYS Insurance Fund, Personnel Office
15 Computer Drive West
Albany, NY 12205

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 Candidates who are not current state employees are encouraged to
apply by completing the NYS application form. To apply, please mail
your NYS application form to:
NYS Insurance Fund, Personnel Office
15 Computer Drive West
Albany, NY 12205

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

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 ApplyingIf applying for transfer, please email your resume and cover letter to hr@nysif.com, and include the position title and Vacancy ID number in the subject line.

If applying for list eligibility with the NYS application form, please mail to:
NYS Insurance Fund, Personnel Office
15 Computer Drive West
Albany, NY 12205

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