Fair Hearing Specialist

State of Vermont • Waterbury, VT

15h • Hybrid

About The Position

The Fair Hearing Specialist (FHS) works in the Department of Vermont Health Access Health Care Appeals unit, providing customer service to members who disagree with Medicaid or Vermont Health Connect health eligibility determinations. The role involves reviewing cases in detail, tracking policy and rule changes, correcting system errors, and sometimes contacting customers to confirm unfavorable decisions. The specialist works closely with the Assistant Attorney General's office, which represents the department in hearings.

The position requires managing competing priorities, multitasking, meeting deadlines, and providing customer service in difficult circumstances. Work is performed in a standard office setting in a supportive hybrid environment, with a Monday–Friday schedule. Some travel may be necessary, and work outside typical business hours may be expected. The incumbent may be required to appear in court on behalf of the State of Vermont. Interactions with upset or emotional clients and frequently heavy workloads may occur.

Requirements

• Bachelor's degree and at least one year of experience at or above a technical-level role involving research, customer service, review of healthcare services, or a similar field; or an associate's degree and at least three years of such experience; or a high school diploma or equivalent and at least five years of such experience.
• Pass any background investigation applicable to the position.

Responsibilities

• Conduct detailed reviews of cases brought by members who disagree with Medicaid or Vermont Health Connect healthcare eligibility determinations.
• Track changes to policies and rules.
• Correct errors in the system and, in some instances, contact customers to confirm unfavorable decisions.
• Work closely with the Assistant Attorney General's office, which represents the department in hearings.
• Manage conflicting priorities and multitask as needed.
• Meet deadlines and provide superior customer service under difficult circumstances.

Benefits

• 80% state-paid medical premium and a dental plan at no cost for employees and their families.
• 12 paid holidays each year and a generous leave plan.
• State-paid Family and Medical Leave Insurance (FMLI).
• State defined-benefit pension plan and deferred compensation 457(b) plan.
• Tuition reimbursement.
• Flexible spending accounts for healthcare and childcare reimbursement.
• Low-cost group life insurance.
• Incentive-based wellness program.
• Eligibility for the Public Service Student Loan Forgiveness Program.

What This Job Offers

• Job Type: Full-time