Eligibility Hearing Officer
About The Position
The Department of Medical Assistance Services (DMAS) is hiring an Eligibility Hearing Officer in its Appeals Division. The officer reviews appeal requests, case documents, and other evidence to prepare for and conduct client eligibility appeal hearings, then renders written appeal decisions at the highest administrative level in accordance with fair hearing principles and established timeframes. The position requires applying relevant laws, rules, regulations, and administrative procedures; observing due process standards; conducting legal research; and objectively evaluating facts, evidence, and law to reach defensible decisions and recommendations. The officer independently manages a caseload and deadlines while providing respectful customer service, ensuring appellants receive due process, supporting a collaborative work environment, and producing high-quality work. Business needs include in-office work, including in-person hearings. Telework may be available under agency policy but can be modified or ended based on performance or business needs.
Requirements
- Experience independently managing a caseload to meet established timeframes.
- Considerable work-related experience applying rules to facts to reach logical, legally supportable conclusions.
- Knowledge of administrative law and/or appeals procedures.
- Considerable knowledge of legal research methodologies, including computerized legal research.
- Considerable experience with technology, including MS Office.
- Considerable experience interpreting, applying, and analyzing complex federal and state laws, regulations, policies, or case law.
- Experience meeting deadlines.
- Experience working with internal and external stakeholders.
- Considerable experience in legal analysis and legal writing.
Nice To Haves
- Admission to the Virginia State Bar in good standing.
- Experience drafting appeal decisions.
Responsibilities
- Review appeal requests, case documents, and other appropriate evidence in preparation for client eligibility appeal hearings.
- Conduct client eligibility appeal hearings.
- Render written appeal decisions at the highest administrative level in accordance with fair hearing principles and established timeframes.
- Apply laws, rules, regulations, and administrative procedures, and observe due process standards when making decisions.
- Conduct legal research and analyze facts, evidence, and law to produce legally sound and defensible decisions and recommendations.
- Independently manage a caseload and meet deadlines.
- Provide respectful customer service, ensure appellants receive full due process, support a collaborative work environment, and produce quality work.
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
