Summary
This job involves overseeing medical consultants who help decide disability claims for Washington state, making sure their work is accurate, on time, and follows the rules.
You'll manage workflows, check performance, handle reports, and support the team to ensure fair decisions that affect people's access to benefits.
It's a good fit for experienced DSHS staff with a background in disability adjudication who are organized, good at communicating, and enjoy problem-solving in a remote setting.
Full Job Description
DSHS DDS Adjudicator 5
DSHS’s Economic Services Administration, Disability Determination Services (DDS), is seeking a Medical Consultant Liaison Specialist 5 (DDS Adjudicator 5) to oversee the workflow, performance, and contract compliance of Medical Consultants, ensuring timely and accurate medical referrals through effective communication, support, and process management. This role plays a vital part in upholding the quality, consistency, and timeliness of determinations that impact the lives of Washingtonians.
This position is open exclusively to DSHS employees. The role is primarily remote, with duty station options in Spokane, Federal Way, or Olympia. King County employees receive 5% premium pay in addition to the advertised salary and are eligible to receive a free ORCA card for transportation use.
Some of what you'll do:
- Monitor and manage Medical Consultant (MC) queues to ensure timely referral completion and identify when out-of-state assistance is needed
- Ensure ongoing compliance with established DDS and SSA business processes and policies
- Oversee MC performance and contract compliance, including quality assurance and productivity monitoring
- Provide guidance and ongoing support to MCs, DDS staff and management, addressing questions related to referrals, queues, and policies
- Process monthly MC invoices and ensure accurate compensation reporting
- Conduct quarterly license checks for MCs, monitor license renewals, and ensure completion of required MC training
- Prepare, analyze, and share Business Intelligence (BI) reports pertaining to MC referrals, productivity, and contract adherence
- Respond to Help Desk requests and manage the Second Opinion process according to established procedures
- Plan, facilitate, and document quarterly MC meetings, including agenda creation, minute-taking, and follow-up on action items
Who should apply?
A Bachelor's degree
OR
Professional experience working with disability, medical or insurance claims adjudication or investigation, health care, unemployment, workers compensation, social services, or related field will substitute, year for year, for education
AND
Four years of recent experience as an adjudicator of Social Security Disability insurance. Must have successful experience adjudicating all claim types
Note: Recent years of experience must be gained within four years of application
What we're looking for: - Excellent working knowledge of Social Security and DDS policies, procedures, and business processes
- Ability to clearly and professionally communicate complex issues
- Strong organizational and time management skills
- High attention to detail
- Effective collaboration and teamwork
- Adaptability to change
- Proactive problem-solving and initiative
- Leadership and meeting facilitation skills
- Commitment to equity and inclusion
- Customer service focus
- Commitment to continuous learning and improvement
- Accountability and reliability
Along with your application please attach: Questions?
Email the recruiter at morgan.daggi@dshs.wa.gov
and reference job number 00018.
The Department of Social and Health Services’ (DSHS) vision that people find human services to shape their own lives requires that we come together with a sense of belonging, common purpose, shared values, and meaningful work.
It is crucial to our agency’s vision that you bring a fairness, access, and social justice commitment to your work with DSHS.
We strive to support all Washingtonians, including Black, Indigenous, and People of Color, people with physical, behavioral health, and intellectual disabilities, elders, LGBTQIA+ individuals, immigrants and refugees, and families building financial security.
Additional Information
Prior to a new hire, a background check including criminal record history may be conducted. Information from the background check will not necessarily preclude employment but will be considered in determining the applicant's suitability and competence to perform in the job. This announcement may be used to fill multiple vacancies. Employees driving on state business must have a valid driver's license. Employees driving a privately owned vehicle on state business must have liability insurance on the privately owned vehicle.
Washington State Department of Social & Health Services is an equal opportunity employer and does not discriminate in any area of employment, its programs or services on the basis of age, sex, sexual orientation, gender, gender identity/expression, marital status, race, creed, color, national origin, religion or beliefs, political affiliation, military status, honorably discharged veteran, Vietnam Era, recently separated or other protected veteran status, the presence of any sensory, mental, physical disability or the use of a trained dog guide or service animal by a person with a disability, equal pay or genetic information. Persons requiring accommodation in the application process or this job announcement in an alternative format may contact the Recruiter at (360) 725-5810. Applicants who are deaf or hard of hearing may call through Washington Relay Service by dialing 7-1-1 or 1-800-833-6384.