Hearing Officer

Commonwealth of Massachusetts•Springfield, MA

About The Position

The Board of Hearings, within the Executive Office of Health and Human Services’ Office of Medicaid, adjudicates appeals involving MassHealth applicants, members, appeal representatives, and providers. The Hearing Officer presides impartially over MassHealth Fair Hearings under 130 CMR 610.000 et seq., G.L. c. 30A and c. 118E, and related regulations, as well as provider Claims for Adjudicatory Hearings under 130 CMR 450.241 and 450.243 and the Standard Adjudicatory Rules of Practice and Procedure at 801 CMR 1.00 et seq. The role serves as the impartial fact finder in administrative proceedings concerning the appropriateness of actions or inactions by MassHealth, its contractors, or agents. The Hearing Officer conducts hearings and related prehearing conferences, rules on procedural and evidentiary matters, develops the record, and issues fair, independent, impartial decisions based on the evidence and applicable law. The position also conducts legal research and analysis, prepares decisions and reference materials, supports staff education and training, responds to general inquiries, and may mediate disputes or preside over remanded matters. The position requires a Juris Doctor degree, admission to the Massachusetts Bar, and at least three years of full-time or equivalent part-time professional experience practicing law. A current and valid motor vehicle driver’s license at a class level specific to the assignment may also be required. Education, licensure, and certifications will be verified. A criminal and tax history background check will be conducted before hiring.

Requirements

Juris Doctor (JD) degree.
Admission to the Massachusetts Bar.
At least three years of full-time, or equivalent part-time, professional experience in the practice of law.
Knowledge of legal theory, principles, and practices, including administrative and constitutional law.
Knowledge of procedures followed in administrative proceedings.
Knowledge of methods for technical and general report writing for Board of Hearings reports.
Ability to read and interpret legal documents, including memoranda, decisions, briefs, opinions, and contracts.
Ability to understand and apply laws, rules, and regulations governing operations and assigned unit activities through fair hearing proceedings.
Ability to exercise sound judgment and render impartial decisions.
Ability to make decisions and act quickly and appropriately in stressful situations while maintaining a calm demeanor.
Ability to analyze legal data, determine its applicability, find facts, draw conclusions, and render appropriate decisions.
Ability to explain procedures, guidelines, and policies governing Board of Hearings operations and activities.
Ability to write concisely, express thoughts clearly, and develop ideas in a logical sequence.
May be required to hold a current and valid motor vehicle driver’s license at a class level specific to the assignment.

Nice To Haves

Knowledge of terminology, symbols, and standard abbreviations used in legal and administrative practice.
Ability to understand, explain, and apply laws and rules governing the presentation and admissibility of evidence.
Knowledge of legal research methods and procedures.
Ability to exercise discretion in handling confidential information and maintain confidentiality through hearing proceedings and decision publication.
Ability to work independently.
Ability to assemble information in accordance with established procedures.
Ability to establish and maintain harmonious working relationships with others.
Ability to supervise, including planning and assigning work and identifying hearing staff education and training needs.
Knowledge of principles and practices of supervisory techniques.

Responsibilities

Identify and rule on jurisdictional issues, representation issues, and issues for hearing; explain the procedural format to the parties.
Administer oaths or affirmations to witnesses and interpreters, and inform appellants who are not fluent in English about interpreter options.
Help parties make a full and free statement of the facts and ensure orderly presentation of evidence and a full opportunity to present claims, witnesses, and evidence.
Order, rule on, and preside over prehearing conferences to identify witnesses, evidence, and arguments and to encourage settlement; clarify issues and promote efficient presentations.
Introduce relevant regulations, statutes, memoranda, and other materials into the record as appropriate.
Receive, rule on, exclude, or limit evidence; conduct legal research and analyze evidence to find facts and reach conclusions of law.
Ensure the hearing record is complete, including appropriately marked documentary exhibits and correctly labeled, dated, and time-sequenced recordings.
Rule on requests for continuances, reopening, reconvening, and motions under applicable laws and regulations.
Render fair, independent, and impartial decisions based on the issues and evidence, formatted to preserve confidentiality.
Assign appropriate issue codes to decisions for public placement on the decision drive.
Preside over regulatory or court-ordered remands and, when requested, mediate disputes under applicable regulations.
Provide monthly presentations to hearing staff on hearing matters, legal research, regulations, and outcomes; review relevant court decisions and opinions.
Maintain current regulation volumes, use the designated library and decision drive, and establish the Board of Hearings reference library as assigned.
Answer general inquiries from the Agency and public about the Board of Hearings and its rules, while maintaining impartiality and avoiding ex-parte communications about pending matters.
Perform related duties, including generating reports, assisting with hearing and conference scheduling, reviewing reference materials, and participating in education and training.