JOB TITLE: DISABILITY PHYSICIAN ADMINISTRATOR

JOB CODE: 33301

DEFINITION: This is professional supervisory medical work of an administrative nature in directing the medical evaluation of disability claims.

An employee in this job performs professional supervisory medical and administrative work as a medical program expert within the Bureau of Disability Determination (BDD). Work involves supervising a staff of physicians responsible for evaluating the medical aspects of individual disability claims; reviewing physician assessments to ensure sound evidence, accuracy, completeness, and adherence to regulations and procedures; serving as a medical liaison with the Social Security Administration; and developing and implementing policy and procedures regarding the disability determination process. Work may also involve performing public relations work as a medical expert on behalf of BDD. General managerial oversight is received from an administrative supervisor.

EXAMPLES OF WORK: (NOTE: The examples of work are representative of the work, but every position classified to this job may not perform all examples of work listed. Conversely, this is not an all-inclusive list of work examples.):

• Reviews a sampling of physician assessments and recommendations to ensure programmatic compliance.

• Provides guidance and assists staff in the application of medical guidelines used in adjudicating disability claims.

• Applies expert medical knowledge to collaboratively formulate policies and procedures regarding new laws, regulation updates, and instructions regarding the medical review process for disability determinations.

• Serves as a primary point of contact with the Social Security Administration to clarify or resolve issues pertaining to medical matters.

• Reviews medical matters identified through quality assurance reviews to determine if a general application can be utilized in future claims.

• Represents the bureau as a medical expert with advocacy groups and other agencies or programs.

• Collaborates with the management team and executive staff on program needs and goals.

• Facilitates the exchange of information between medical staff and adjudication staff.

• Conducts training to discuss laws, regulations, and procedures to ensure consistent medical interpretation of the case review process.

• Performs the full range of supervisory duties.

• An employee in this job may participate in the performance of subordinates’ work consistent with operational or organizational duties.

• Performs related work as required.

ENTRY LEVEL KNOWLEDGES, SKILLS, AND ABILITIES:

• Knowledge of the principles, practices, and techniques in the field of modern medicine.

• Knowledge of developments in methods and techniques of testing for diagnoses and severity of diseases and impairments.

• Knowledge of the medical aspects of disability program regulations under the Social Security Act.

• Ability to communicate effectively orally.

• Ability to communicate effectively in writing.

• Ability to establish and maintain effective working relationships.

FULL PERFORMANCE KNOWLEDGES, SKILLS, AND ABILITIES: (NOTE: These are expected of an employee performing the work of this job at the full performance level. These may not be evaluated by the State Civil Service Commission or used for Civil Service examination purposes and are not position-specific performance standards.):

• Knowledge of disability claims adjudication principles and practices.

• Ability to apply policy and regulation changes to BDD operations.

MINIMUM EXPERIENCE AND TRAINING: (NOTE: Based on the Entry Level Knowledges, Skills, and Abilities):

• One year as a Disability Physician Specialist;

or

• Four years of post-residency experience in the medical specialty or subspecialty practiced.

SPECIAL REQUIREMENTS:

• Possession of an active unrestricted or active retired license to practice medicine in the Commonwealth of Pennsylvania as issued by the Pennsylvania State Board of Medicine or the Pennsylvania State Board of Osteopathic Medicine.

• All employees must successfully complete the continuing medical education required to maintain an active unrestricted or active retired license to practice medicine in the Commonwealth of Pennsylvania as issued by the Pennsylvania State Board of Medicine or the Pennsylvania State Board of Osteopathic Medicine.