Internal Medicine Consultant

About the role

C2 ALASKA, LLC Remote The Internal Medicine/Internist MEC shall provide meaningful, prompt, reliable case services which require the assessment of initial disability evidence and assessment of evidence during the reconsideration process as well as non-case services where answers or opinions are provided regarding specific medical topics.

Responsibilities

• Conduct medical case reviews in accordance with Social Security Administration (SSA) policies and procedures.
• The purpose of these reviews is to provide a medical assessment for the Disability Determination Services (DDS), Disability Processing Branch (DPB), Disability Processing Unit (DPU) or any other SSA adjudicating component.
• Do not review or complete a medical assessment for any reconsideration case for which he/she provided the initial assessment.
• Do not provide a medical assessment or review on any case he/she had any prior involvement in a treatment capacity.
• Perform all reviews within a timely manner - time to complete a case varies based on case complexity reviewer experience; preferably within one business day of assignment but not to exceed two business days for review.
• Review all medical and non-medical evidence of record; including any prior file information.
• Identify and interpret all medical evidence, applying all current SSA disability policies and procedures.
• Request additional evidence, only when the evidence in the file is insufficient to assess in accordance with current SSA disability policies and procedures.
• Compose medical assessments (or opinions) in a professional manner, in a formal tone (third person), free of jokes, personal anecdotes, emotion, biases, prejudices or colloquial expressions.
• Write a narrative to convey their individualized review in a clear and concise manner.
• Complete case reviews within time frames established by the COR.
• Consult with staff and others (e.g., other MCs/PCs, medical providers, or Medical Advisors) as needed for the review of the case.
• Record findings in the agency electronic processing systems specified by SSA case review policies and procedures.
• Attend required meetings, briefings, and workgroups necessary to perform case reviews (e.g., policy updates, procedural changes) or to discuss administrative issues related to the contract.
• Respond to all communications including instant message or email within 48 hours of logging on to their laptop.
• Provide a satisfactory written assessment, free of spelling and grammatical errors that can be used by others in the disability program.
• Make required corrections to medical assessments when returned from the Office of Quality Review (OQR).
• Report suspected fraud identified in the course of the medical assessment.
• Participate in presentations related to the employee’s medical specialty and the application of disability policies.
• Provide consultation and expertise on policy development issues including written and/or oral summarizations.
• Participate in workgroups, visits, and meetings as requested by SSA to discuss issues related to the disability process; e.g., new medical technologies, revision of medical listings, and other policy issues (this does not include meetings, briefings, or workgroups necessary for case reviews).
• Participate in mentoring or training activities with other MECs.
• Comply with company policies and procedures.
• Complete required annual training.
• Maintain security, privacy, and HIPAA/SSA compliance requirements.
• Participate in performance reviews and quality assurance activities.
• Other duties as assigned by management.

Requirements

• While performing the duties of this job, the employee is regularly required to sit and talk or hear.
• The employee may use repeated motions that include the arms, wrists, hands and/or fingers.
• The employee is occasionally required to walk, stand, climb, balance, stoop, kneel, crouch, or crawl.
• The employee must occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required by this job include close vision.

Qualifications

• Doctorate of Medicine or Osteopathy from an accredited college approved by the Council of Medical Education and Hospitals of the American Medical Association or Doctor of Osteopathy from a college accredited by the American Osteopathic Association.
• Completion of a residency and/or fellowship.
• Possess and maintain a Valid unrestricted license to practice medicine within one of the 50 states, the District of Columbia, Puerto Rico, or the U.S. Virgin Islands.
• Minimum one (1) year experience practicing as an Internist.

Skills

• Knowledge of and ability to work in DCPS/NCPS, Disability Case Processing System, IMAGEN, eView/DMA.
• Proficiency in the English Language- The MC/PC must be capable of providing a comprehensive, technically accurate and logically written document addressing the claimant's medical evidence related to the rules of disability.
• Basic Computer Skills-MC/PC’s must be able to perform basic tasks with a compute, including, but not limited to sending and receiving email, conducting research, interacting with