Disability Reviewer

🔥 5 minutes ago

🧀 Wisconsin – Remote

🧀 Wisconsin – Remote

💵 $50.7k - $72.4k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Review and analyze complex medical, psychological, developmental, and functional information for children applying for or participating in Wisconsin’s Katie Beckett Medicaid program • Develop disability determination recommendations using medical evidence, functional limitations, Social Security Act requirements and disability criteria, policies, regulations, procedures, and quality standards • Evaluate medical terminology, disease processes, diagnostic testing, treatment practices, physical and mental impairments, and other relevant evidence • Identify when additional medical information is necessary to complete a review • Prepare electronic case documentation, written review requests, case summaries, determination records, and required notifications • Maintain confidentiality and comply with applicable regulations and program requirements • Independently manage an assigned disability caseload • Collaborate with reviewers, clinical consultants, supervisors, and operational partners to research discrepancies, resolve complex cases, and reach logical and objective conclusions • Travel quarterly to Madison, Wisconsin for meetings or other business needs

🎯 Requirements

• Professional experience working with children who have disabilities and/or complex medical needs • Experience evaluating medical, emotional, psychological, developmental, and functional conditions • Experience reviewing and analyzing medical, psychological, developmental, clinical, or other evidentiary records • Ability to develop logical, objective, and well-supported recommendations • Strong analytical, critical-thinking, written communication, organizational, and attention-to-detail skills • Ability to independently manage priorities, deadlines, and a disability-related caseload accurately and timely • Bachelor’s degree in a human services-related field with relevant clinical experience, or an associate degree in a human services-related field with equivalent relevant experience • Backgrounds in nursing, psychology, social work, human services, or related therapies preferred • Strong computer skills • Ability to work effectively with electronic medical and evidentiary records • Experience with CARES Worker Web (CWW) preferred • Must reside within Wisconsin • Ability to work 40 hours per week • Availability Monday through Friday during Wisconsin Department of Health Services core hours of 9:00 a.m.–3:00 p.m. Central Time • Maintain a private, distraction-free workspace • Reliable hard-wired high-speed internet with minimum 25 Mbps download and 10 Mbps upload; Wi-Fi is not permitted as the primary connection

🏖️ Benefits

• Medical, dental, and vision benefits • 401(k) options • 401(k) employer match • Flexible vacation policy • Educational assistance • Leadership and technical development academies • Flexible work hours • Career development and continuous learning opportunities • Work-life balance