Paralegal IV

Empower AI Inc. • Remote,

32d • $56 - $86

About The Position

Empower AI is AI for government. Empower AI gives federal agency leaders the tools to elevate the potential of their workforce with a direct path for meaningful transformation. Headquartered in Reston, Va., Empower AI leverages three decades of experience solving complex challenges in Health, Defense, and Civilian missions. Our proven Empower AI Platform® provides a practical, sustainable path for clients to achieve transformation that is true to who they are, what they do, how they work, with the resources they have. The result is a government workforce that is exponentially more creative and productive. For more information, visit www.Empower.ai.
Empower AI is proud to be recognized as a 2024 Military Friendly Employer by Viqtory, the publisher of G.I. Jobs. This designation reflects the company’s commitment to hiring and supporting active-duty and veteran employees.

Requirements

• Bachelor’s degree in legal studies, paralegal studies, health policy, public administration, or a related field, or equivalent education and experience.
• 10+ years of progressively responsible legal, regulatory, compliance, administrative appeals, or healthcare policy experience.
• 5+ years drafting or substantively reviewing legal briefs, memoranda, recommendations, proposed decisions, orders, opinions, or comparable analytical work products.
• Knowledge of Medicare or Medicaid law, healthcare appeals, managed care, or regulatory oversight.
• Demonstrated strength in complex legal research, neutral analysis, decision writing, quality review, communication, organization, and deadline management.
• Proficiency with Microsoft Office and legal, document, or case-management systems; ability to obtain required suitability and system access.

Nice To Haves

• Juris Doctor degree from an accredited law school and active bar admission in a U.S. jurisdiction.
• Experience with administrative hearings, appeals, adjudications, decision writing, or judicial clerkship work.
• Experience supporting federal hearing officers or administrative law judges.
• Direct experience with CMS appeals, Medicare Advantage, RADV, or healthcare regulatory adjudication.

Responsibilities

• Lead neutral legal and adjudicative support for CMS Office of Hearings activities, primarily Medicare Advantage Risk Adjustment Data Validation (RADV) appeals.
• Research complex issues, synthesize multidisciplinary findings, and draft clear, defensible recommendations and proposed decisions for the CMS Hearing Officer.
• Review RADV appeal requests, briefs, motions, hearing records, and supporting documentation.
• Research and apply statutes, regulations, CMS guidance, policies, procedures, and precedent.
• Draft and review legal memoranda, orders, notices, recommendations, and proposed decisions.
• Evaluate jurisdictional, procedural, and substantive issues and escalate material risks or deficiencies.
• Integrate legal, medical, coding, and case-management findings into neutral, well-supported recommendations.
• Provide final quality review, guide legal support staff, coordinate with CMS and project leadership, and maintain compliant case records.

What This Job Offers

• Job Type: Part-time
• Career Level: Senior