Disability Determination Manager I

Health & Human Services; North Carolina; On-site; USD 61,000 - 107,000; Full time

Benefits offered by this job

Health insurance options

Standard and supplemental retirement

NCFlex program

Paid vacation and sick leave

Paid parental leave

Job summary

North Carolina Department of Health and Human Services (DHHS) in Raleigh, NC, seeks a Disability Determination Manager I (S) to oversee claims development and adjudication for SSA and Medicaid disability programs. The role requires leading training for new examiners and providing guidance to experienced staff in an electronic case processing system.

The position emphasizes supervising claims workflow, ensuring accuracy, and maintaining performance standards in a busy DDS environment.

Qualifications

• At least 36 months of documented experience as a Disability Analyst at a State DDS office or related SSA component.
• Experience adjudicating Initial, Reconsideration, Age 18 Redetermination, and Continuing Disability Reviews.
• Demonstrated ability to move quickly between tasks with strong organizational skills.
• Proficiency in computer applications and SSA electronic case processing system.

Responsibilities

• Provide lead supervision for in-service training of new examiners and guidance of experienced examiners.
• Direct all facets of claims development and adjudication in supervisory absence.
• Process unattended claims and assist examiners with performance issues using an electronic environment.

Skills

Disability analysis

Case adjudication

Training/mentoring

Education

Bachelor's degree

Tools

SSA electronic case processing system

Job description

Agency Dept of Health and Human Services Division Disability Determination Services Job Classification Title Disability Determination Manager I (S) Position Number 65009584 Grade NC17

About Us

The North Carolina Department of Health and Human Services (DHHS) is one of the largest, most complex agencies in the state, and has approximately 17,000 employees. It is responsible for ensuring the health, safety, and well-being of all North Carolinians, providing human service needs for special populations including individuals who are deaf, blind, developmentally disabled, and mentally ill, and helping poor North Carolinians achieve economic independence.

Description of Work

This position is located at the Division of Disability Determination Services (DDS) at the Department of Health and Human Services in Raleigh, NC. This agency makes medical entitlement decisions on Social Security, Supplemental Security Income and Medicaid disability claims. This position requires an experienced disability examiner with superior skills in SS and Medicaid disability claims development and adjudication. A Case Consultant has lead responsibility for in-service training of new examiners and guidance of experienced examiners. The consultant provides direction in all facets of claims development and adjudication. The consultant also uses his/her skills by processing claims that are unattended due to absences, assisting examiners experiencing performance problems, providing training and assessing general performance deficiencies. Many of the consultants' duties are performed in an electronic environment. Production of forms and evaluations are done utilizing the computer. This includes making electronic images of medical records. The Case Consultant provides the full range of supervisory functions in the supervisor’s absence.

Knowledge Skills and Abilities/Management Preferences

Salary Grade Range $60,881 - $106,544Recruitment Range $60,881 - $95,217Internal Posting - This Is An Internal Posting Open Only For Current North Carolina Department Of Health And Human Services Employees, And Eligible RIF Candidates From North Carolina State Government, or Current Temporary Employees. Candidates now meet the minimum qualifications of a position if they meet the minimum education and experience listed on the vacancy announcement. The Knowledge, Skills, and Abilities (KSAs)/ Management Preferences are not required. Applicants who possess the following skills are preferred:

• At least 36 months of documented experience as a Disability Analyst at a State DDS office or related SSA component.
• Documented experience adjudicating all of the following claim types: Initial, Reconsideration, Age 18 Redetermination Cases, Continuing Disability Reviews.
• Demonstrated proficiency in moving quickly between tasks, exhibiting strong organizational skills and recognizing complex issues.
• Proficiency in use of computer applications and software specific to the Social Security Administration and an electronic case processing system.

Posting closes at 11:59 p.m. the night before the closing date. Position is funded in part through federal funds.

About Disability Determination Services

The Division of Disability Determination Services (DDS) makes medical determinations for Social Security and state Medicaid Disability claims. Social Security Disability claims are initially processed at local SSA field offices, and the case is sent to DDS to evaluate disability. DDS is responsible for obtaining medical evidence and making the initial determination on whether a person, or a claimant, is disabled or blind under the law. DDS also processes Medicaid disability claims for the state of North Carolina. Medicaid disability claims can be filed by contacting a county Department of Social Services office. Once a Medicaid disability application is received, DDS will develop medical evidence and make a determination on disability using the same protocols as outlined for Social Security Disability benefits.

Compensation and Benefits

• Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis).
• Employees also receive paid vacation, sick, and community service leave.
• In addition, paid parental leave is available to eligible employees.
• Visit website for benefits.

Supplemental Contact Information

The North Carolina Department of Health and Human Services (DHHS) is an Equal Opportunity Employer that embraces an Employment First philosophy, which consists of complying with all federal laws, state laws, and Executive Orders. We are committed to reviewing requests for reasonable accommodation at any time during the hiring process or while on the job. For more information about DHHS: https://www.ncdhhs.gov/. DHHS uses the Merit-Based Recruitment and Selection Plan to fill positions subject to the State Human Resources Act with the most qualified individuals. Hiring salary will be based on relevant qualifications, internal equity, and budgetary considerations pertinent to the advertised position. In accordance with the Governor’s Executive Order 303, our agency supports second-chance employment for individuals who were previously incarcerated or justice-involved. We invite all potential applicants to apply for positions for which they may be qualified.

Minimum Education and Experience

Bachelor’s degree from an appropriately accredited institution and four years of progressive experience as a Disability Determination Specialist. OR An equivalent combination of education and experience. See the Education and Experience Equivalency Guide for details.

EEO Statement

The State of North Carolina is an Equal Employment Opportunity Employer and dedicated to providing employees with a work environment free from all forms of unlawful employment discrimination, harassment, or retaliation. The state provides reasonable accommodation to employees and applicants with disabilities; known limitations related to pregnancy, childbirth, or related medical conditions; and for religious beliefs, observances, and practices.