Public Consulting Group

Case Management Specialist 2

Job Locations US-CA-Santa Ana
Posted Date 2 months ago(5/28/2021 10:44 AM)
Job ID
2021-6664
# of Openings
1
Category
Operation Support
Type
Regular Full-Time
Practice Area
Human Services

Overview

About Public Consulting Group

Public Consulting Group, Inc. (PCG) is a leading public sector solutions implementation and operations improvement firm that partners with health, education, and human services agencies to improve lives. Founded in 1986 and headquartered in Boston, Massachusetts, PCG has over 2,500 professionals in more than 60 offices worldwide. PCG’s Human Services practice helps state, county, and municipal human services agencies to achieve their performance goals in order to better serve populations in need. PCG’s seasoned professionals offer proven solutions to help agencies design programs, services, and systems; increase program revenue; cut costs; and improve regulatory compliance with state and federal regulations. To learn more, visit http://www.publicconsultinggroup.com/humanservices/.

 

       Social Security Advocacy Management Service SSAMS™:

 

PCG’s SSAMS™ team provides comprehensive technology driven Social Security disability identification and advocacy services.  Our work encompasses contracts with public sector child welfare, TANF, Medicaid, and private sector individuals and pension/retirement plan agencies to identify and enroll disabled individuals onto Social Security’s Supplemental Security Income (SSI) and/or Social Security Disability Insurance (SSDI) programs.

 

PCG SSAMS™ provides advocacy services for Orange County, California, Social Services Agency (SSA), assisting hard to serve individuals with medical and/or mental health impairments, and who may qualify for federal benefits, in applying for and obtaining SSI, SSDI and, State Supplementary Payment (SSP). These programs are designed to promote employment opportunities and self-sufficiency.  PCG assists potentially eligible CalWORKs/GR clients with the application process for SSI/SSP and SSDI benefits, including providing representation for claims pending at the Social Security Administration from the initial level through the hearing and appeals level.

Responsibilities

        Overall Responsibilities:

 

  • The Case Management Specialist is responsible for managing claims processing activities, including the development of SSI/SSDI applications at the initial and reconsideration level of the Social Security Administration’s (SSA) disability adjudication process, with the objective of producing the highest likelihood of award for each claim.  Additionally, the Case Management Specialist is responsible for managing client communications, maintenance of contract compliance, and maintenance of project targets related to related to claims processing activities. Responsibilities include:

    ·       Prepare for and conduct client meetings, including preparation if Power Point presentations and meeting minutes.

    ·       Prepare Internal and External Reports, including client monthly summary report and internal monthly data reconciliation.

    ·       Manage client communications related to claims processing activities.

    ·       Maintain contract compliance related to claims processing activities.

    ·       Participate in the training and development of project team members

    ·       Track and maintain project production and performance targets, including an average allowance rate of 55% at the Initial and Reconsideration level.

    ·       Manage a caseload size of approximately 85 Initial and Reconsideration claims.

    ·       Conduct a review of all assigned claims to become familiarized with the claim and utilize discretion and judgment to identify the merit of the claim as it relates to Social Security disability criteria, and to identify the best strategy to produce the highest likelihood of success for the claim.

    ·       Identify and request necessary medical, educational, and vocational evidence supporting the alleged disability.

    ·       Submit medical, educational, and vocational evidence to Disability Determination Services (DDS).

    ·       Maintain regular contact with claimant to provide status updates, collect information regarding new or changing conditions related to their disability, confirm Consultative Examinations (CE) appointments, and provide general customer service.

    ·       Maintain regular contact with SSA and DDS to obtain status updates or assist them in collecting data or evidence.

    ·       Review Notice of Award with claimant.

    If a claim is denied:

    ·       Review decision to determine the cause for the denial and confirm that DDS considered all evidence.

    ·       Collect any new evidence, if available.

    ·       Review case with the Team Lead to gain their assessment on whether to appeal or close the claim.

    ·       If decided by the Team Lead to file an appeal, complete all forms to submit an appeal.

    ·       Claims that are being appealed to the hearings level will be transitioned to a Hearings Analyst.

    At all times, the SSAMS Case Management system must be kept up to date, contain accurate data, and clear and detailed notes.  The Case Management Specialist will follow defined policy and procedures and meet specified processing times and deadlines.

Qualifications

       Required Skills:

 

  • Intermediate skill with Microsoft office products.
  • Strong written and verbal communication skills in both English and Spanish.
  • Strong Interpersonal skills, including the ability to establish working relationships with federal, state and county agencies, as well as the public.
  • Ability to recognize and maintain confidentiality of all materials in the work setting.
  • Knowledge and understanding of SSA’s adjudication process.
  • Knowledge and understanding of SSA’s medical, psychological, and vocational criteria.
  • Ability to analyze complex medical, vocational, and educational data in relation to Social Security disability criteria.
  • Ability to work independently with minimal supervision.
  • Knowledge and understanding of the relationship between SSI/SSDI and Medicaid/Medicare.
  • Ability to understand and follow defined business processes in conducting the work.

 

            Required Experience:

  • Education:

    A Bachelor’s degree

    Experience:

    Social Security disability advocacy, human service, or health related fields

    Certification:

    SSI/SSDI Outreach, Access, and Recovery (SOAR) certified (can obtain post-employment).

 

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EEO Statement

Public Consulting Group is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PCG, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PCG will not tolerate discrimination or harassment based on any of these characteristics. PCG believes in health, equality, and prosperity for everyone so we can succeed in changing the ways the public sector, including health, education, technology and human services industries, work.

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