City of Rochester, NY
Full Job Description
$58,562.00 – $77,217.00 Annually
Rochester Fire Department
9/26/2022 11:59 PM Eastern
The employee in this title provides technical and administrative support in the overall management of a self-funded workers compensation plan. The position independently manages workers compensation claims resulting from work related injuries effecting employment leave, employee attendance, and job performance. The Case Manager independently manages medical cases from the initial claim review to the final payment, and all aspects in-between, including but not limited to, verifying and approving claim vouchers for payment, monitors medical costs associated with work related instances, maintaining work related health records, and representing the employer at negotiations. Maintaining confidentiality of private information is critical to this position. General supervision is received from higher ranking personnel. Related work is performed as required.
Typical Work Activities
Establishes and implements guidelines for departments to follow when requesting medical evaluation of employees regarding their ability to perform their work duties;
Instructs department supervisory personnel of the type and content of documentation necessary (work requirements, employee’s performance, etc.) to proceed with a medical case, including requirements that may be outlined under Workers’ Compensation Law, Fair Labor Standards, City Charter, and NYS Civil Service Law;
Determines validity of compensation and other claims, and prepares reports and supervises the processing of necessary forms and paperwork;
Manages medical cases for active duty, disabled, and retired employees;
Assesses physicians’ reports describing the physical and medical condition of employees applying for workers’ compensation, disability, and similar insurance claims;
Determines and authorizes the dollar amount the City will pay on medical bills submitted for covered employees, based on an evaluation of the necessity of the action taken and the NYS medical fee schedule;
Works with injured or ill employees and their physicians, physical therapists, employers, health insurance companies, legal counselors, and other concerned parties to develop an appropriate and cost-effective rehabilitation and return-to-work plan;
Meets with employees to discuss their cases at their physicians’ office, their job site, in the hospital or as otherwise indicated;
Facilitates communication between department, employee, and the City’s physician regarding steps to be taken in the resolution of cases;
Reads medical summaries and laboratory reports, obtains additional patient information;
Develops procedures and systems to meet state and federal mandated record keeping and reporting requirements for compensation and insurance claims;
Staff consultant for medical questions regarding employee medical cases, and in the develop of wellness and related current NFPA 1582 regulations;
Schedules and follows calendar of all annual and semi-annual medical testing required for department’s employees;
Distributes safety and wellness literature to employees on a recurring basis;
Collects, assembles, and formats data to produce written reports and correspondence;
Keeps current with changes in the occupational health field such as NYS Workers’ Compensation Law, OSHA guidelines, NFPA 1582 Regulations, medical insurance regulations, and trends in employee wellness programs.
I.A. Bachelor’s degree in Nursing, Physical or Vocational Rehabilitation, Social Work, or other
closely related degree; AND
I.B. Two (2) years of medical or physical rehabilitation case management experience,
developing and implementing treatment plans for sick, injured, or disabled clients; OR;
II.A. Associate’s degree in the areas described in I-A above; AND
II.B. Four (4) years of experience as described in I-B above; OR;
III.A. New York State Registered Nurse (RN); AND
III.B. Three (3) years of experience as described in I.B. above
Preparing Written Material
These questions test for the ability to present information clearly and accurately, and to organize paragraphs logically and comprehensibly. For some questions, you will be given information in two or three sentences followed by four restatements of the information. You must then choose the best version. For other questions, you will be given paragraphs with their sentences out of order. You must then choose, from four suggestions, the best order for the sentences.
Understanding and Interpreting Written Material
These questions test for the ability to understand and interpret written material. You will be presented with brief reading passages and will be asked questions about the passages. You should base your answers to the questions only on what is presented in the passages and not on what you may happen to know about the topic.
Understanding and Interpreting Tabular Material
These questions test your ability to understand, analyze, and use the internal logic of data presented in tabular form. You may be asked to perform tasks such as completing tables, drawing conclusions from them, analyzing data trends or interrelationships, and revising or combining data sets. The concepts of rate, ratio, and proportion are tested. Mathematical operations are simple, and computational speed is not a major factor in the test. You should bring with you a hand-held battery- or solar-powered calculator for use on this test. You will not be permitted to use the calculator function of your cell phone.
Evaluating Conclusions in Light of Known Facts
These questions will consist of a set of facts and a conclusion. You must decide if the conclusion is proved by the facts, disproved by the facts or if the facts are not sufficient to prove or disprove the conclusion. The questions will not be specific to a particular field.
Test Guide:The New York State Department of Civil Service has not prepared a test guide for this examination. However, candidates may find information in the publication ‘General Guide to Written Tests’ helpful in preparing for this test. This publication is available on line at: https://www.cs.ny.gov/testing/testguides.cfm.
For full-time employees:
The City of Rochester offers a complete benefits package to full-time employees including health care, dental, vision, retirement, deferred compensation plans, flexible spending accounts, life insurance, long-term disability, holidays, vacation, and sick leave.
For less-than full-time employees:
The City of Rochester offers numerous growth opportunities to include the potential to transition into full-time, permanent employment
To apply for this job please visit www.governmentjobs.com.