Pulivarthi Group
Location
Jersey City, NJ | United States
Job description
About the Role
Physician Lead of Medical Leave of Absence will provide oversight and direction to Disability and Clinical Case Managers. This role includes business continuity and crisis response, data analytics and metrics.
Responsibilities
Serving as the Occupational Health Physician Lead for the Americas supporting the disability and leave management programs, which includes clinical case management and strategic development of both disability and medical accommodations services.
Clinical case management
Providing clinical oversight and training a team of nurse and behavioral case managers, administrators, claim operations and wellness team.
Conducting disability claim file and peer-to-peer consults addressing claim dynamics.
Liaising and negotiating with treating providers to clarify and confirm medical necessity of disability, and accommodation requests.
Negotiating with employees as needed to streamline return to work.
Consulting with team regarding obtaining and interpreting medical information submitted from treating providers and Independent Medical Evaluations.
Understanding Our Client's wellness resources and utilizing critical thinking skills to optimize all available resources to ensure optimal outcomes for all cases.
Collaborating with Our Client's Human Capital Management and Employment Law teams in managing employees medical leave of absence and accommodations.
Strategy development
Collaborating on the development of clinical content and claim management strategy as needed with operations management.
Leading case management strategy and participating in regular complex case discussions through regular scheduled complex case meetings.
Reviewing and collaborating on development and revision of standard operating procedures and protocols.
Independently interprets business data and can speak to opportunities and operational improvements.
Strong presentation skills, including designing visuals such as PowerPoint.
Requirements
Active state or jurisdiction health care provider licensure.
Possesses Board Certification in Occupational Medicine [or Internal Medicine/Family Practice]
Minimum 5 years' experience in reviewing disability claims across both medical and psychiatric conditions.
Maintains Applicable Certifications, e.g. The American Board of Independent Examiners, The American Academy of Disability Evaluating Physicians (AADEP)
Demonstrates empathy and compassion in interactions with customers as well as in coaching case managers.
Embraces customer service and communicates professionally in all written and verbal interactions.
Champions change management.
Leads initiatives to ensure best practices are implemented and adhered to.
Has a strong working knowledge of medical and behavioral health disorders.
Can quickly and seamlessly integrate into a very fast paced working environment. Independently networks and develops valuable interpersonal business relationships with all stakeholders.
Able to convey clinical opinion clearly and efficiently to non-clinical stake holders, without hesitation.
Receptive to feedback.
Benefits
We offer programs and plans for a healthy mind, body, wallet and life because it's important our benefits care for the whole person. Options include a variety of health coverage options, wellbeing and support programs, retirement, vacation and sick leave, maternity, paternity & adoption leave, continuing education and training as well as a number of voluntary benefit options.
Job tags
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