MEDICAL SERVICES SPECIALIST 2641
DISTINGUISHING
FEATURES OF THE CLASS
An employee in
this class completes medical and social assessments to determine the needs of
potential home care and/or long-term home health care clients. The employee may
authorize specific hours of personal care services and monitor quality of home
care services rendered to eligible Medical Assistance clients or assist
vulnerable populations in locating the appropriate care. The incumbent is expected to exercise
independent initiative and judgment.
Work is performed under general supervision and is reviewed by a
professional or administrative superior through conferences and reports for
conformance to departmental regulations.
Does related work as required.
TYPICAL WORK
ACTIVITIES
Performs medical case management
functions in accordance with established policies and procedures;
Reviews medical reports to determine the nature of
medical care requested, its appropriateness, comprehensiveness and continuity;
Recommends special and complex items
of medical care and services in conformity with established departmental
policies and procedures;
Identifies and compiles information
on individuals unable to obtain an appropriate level of care;
May work closely with hospital
discharge planners;
Establishes and maintains close
contact with physicians and allied professional personnel; informs them of new
and revised policies and procedures of the department;
Reviews and makes recommendations
for revisions of medical policies and procedures as they relate to home care in
accordance with the changing needs of overall medical treatment plans;
Makes on-site visits to providers to
insure compliance with departmental policy, state regulations and the law;
May represent the agency at Fair
Hearings or Legislative Meetings.
FULL PERFORMANCE
KNOWLEDGES, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS
Thorough knowledge of the policies and procedures
involved in medical diagnosis and treatment; thorough knowledge of the medical
terminology used by physicians and other medical personnel; good knowledge of
local, State, and Federal laws affecting social welfare, medical and health
programs; good knowledge of current literature, sources of information and
recent developments in the field of medical assistance programs; ability to
establish and maintain effective working relationships with physicians and
other medical personnel; ability to interpret policies and procedures for
physicians, medical personnel and clerical staff; ability to express oneself
clearly and concisely, both orally and in writing; physical condition
commensurate with the demands of the position.
MINIMUM
QUALIFICATIONS
OPEN COMPETITIVE
Graduation from a college with federally-authorized
accreditation or registration by New York State with a Bachelor's or Master's
Degree in Nursing or other health or human services field, plus two (2) years
of experience as a registered professional nurse in home health care and/or the
review of home health care services for medical necessity or in the delivery of
preventive health care services. Experience
must have been gained within the last ten (10) years.
NECESSARY
SPECIAL REQUIREMENT
At the time of appointment and during employment in this
title, employees must possess a Registered Nurse's license issued by the State
of
Employees must also possess and
maintain a valid license to operate a motor vehicle in
R09/30/13
Competitive
Review 7/23/15