Disability Determination Manager I

State of North Carolina; Raleigh (NC); On-site; USD 61,000 - 107,000; Full time

Benefits offered by this job

Health insurance options

Standard and supplemental retirement

Pre-tax benefits (NCFlex)

Paid vacation/sick leave

Parental leave

Job summary

The Division of Disability Determination Services (DDS) within the North Carolina Department of Health and Human Services seeks a Disability Determination Manager I (S) in Raleigh. You will oversee claims development, adjudication, and in-service training for examiners, ensuring efficient processing of Social Security and Medicaid disability cases.

This role requires senior expertise in disability determinations, strong organizational abilities, and leadership in a fast-paced electronic

Qualifications

• Bachelor’s degree from an accredited institution and four years of progressive experience as a Disability Determination Specialist.
• Experience analyzing SS and Medicaid disability claims.

Responsibilities

• Lead in-service training of new examiners and guidance of experienced examiners.
• Provide direction in claims development and adjudication.
• Process claims in an electronic environment and generate necessary forms/evaluations.

Skills

Disability analysis

SSA/Medicaid claims

Training & supervision

Organizational skills

Education

Bachelor's degree

Tools

SSA electronic case processing system

Computer applications

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 - $106,544

Recruitment Range $60,881 - $95,217

Internal 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.[CC1]

Compensation and Benefits

• Employees can participate in health insurance options
• Standard and supplemental retirement plans
• The NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis)
• Paid vacation, sick, and community service leave
• 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.

Degree/College Credit Verification

Degrees must be received from appropriately accredited institutions. Transcripts, degree evaluations and cover letters may be uploaded with your application.

Veterans’ and National Guard Preference

• Applicants seeking Veteran’s Preference must attach a DD-214 Member-4 Form (Certificate of Release or Discharge from Active Duty) to their applications.
• Applicants seeking National Guard Preference must attach an NGB 23A (RPAS), along with the state application, if they are a current member of the NC National Guard in good standing.
• Applicants who are former members of either the NC Army National Guard or the NC Air National Guard, with honorable discharge and six years of creditable service, must attach a copy of their DD 256 or NGB 22, along with the state application.

ADA Accommodations

Consistent with the Americans with Disabilities Act (ADA) and the Pregnant Workers Fairness Act (PWFA), DHHS is committed to the full inclusion of all qualified individuals. As part of this commitment, DHHS will ensure that people with disabilities, or known limitations covered by the PWFA, are provided with reasonable accommodation. If reasonable accommodation is needed to participate in the job application or interview process, please contact the person indicated below.

Resumes will not be accepted in lieu of completing this application.

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.

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.