Title: Hearing and Legal Services Officer I / Juris Doctor
 
 
Location: Richmond, VA 23219
 
 
Pay Rate: $50.00/Hour on W2 without benefits
 
 
Duration: 5+ months
 
 
Shift Timing (Day/ Evening/ Night): Day
 
 
Note: The candidate must have at least a law degree - Juris Doctor and experience in conducting hearings and VA Bar License
 
 
Job Description:
 
  
 - Review and decide appeals:
 - Go through appeal requests and case documents to prepare for and conduct hearings. Write clear decisions based on facts and legal rules, following fair hearing standards and deadlines.
 - Use legal knowledge:
 - Apply laws, rules, and procedures to make fair and accurate decisions. Do legal research, analyze evidence, and manage your cases independently to meet timelines.
 - Ensure fairness and respect:
 - Provide respectful and professional service to everyone. Make sure each person gets a fair hearing and help maintain a positive team environment.
 
  
 
 
Reporting:
 
  
 - This role reports to the Eligibility Cases Manager.
 
  
 
 
Required knowledge, skills, and abilities (KSAs):
 
  
 - Experience in a fast-paced, deadline-driven environment
 - Experience independently managing a caseload to meet established time frames
 - Experience with internal and external stakeholders
 - Knowledge of administrative law and/or appeals procedures
 - Considerable experience applying rules to facts to reach logical, legally supportable conclusions
 - Considerable experience interpreting, applying, and analyzing federal and state complex laws, regulations, policies, or case law
 - Considerable experience in legal analysis and legal writing
 - Considerable knowledge of legal research methodologies, including computerized legal research
 - Considerable experience with technology, including MS Office
 - Admission to the Virginia State Bar in good standing, or eligible for admission to the Virginia State Bar within six months from the start date in the position.
 
  
 
 
Additional Considerations:
 
  
 - Experience drafting appeal decisions.
 - What work actions and/or decisions are made without prior approval? To what extent is the incumbent required to seek advice and guidance from the supervisor?
 - Independently manage issues and risks proactively and exercise strong business judgment in escalating matters to the Eligibility Cases Manager.
 - Independently research state and federal laws, regulations, and policy.
 
  
 
 
Role & Responsibilities:
 
  
 - Conduct thorough hearing preparation and hearings for all Medicaid appeal cases assigned to inventory.
 - Follow all rules and procedures set by the Appeals Division
 - Use the Appeals Information Management System (AIMS) effectively to track cases, complete tasks, add notes, and manage appeal activities
 - Keep case records accurate and up to date by regularly updating files and logging actions in AIMS
 - Handle your own set of cases and complete hearing prep work on time
 - Research legal issues thoroughly and stay informed about current laws, policies, and regulations that affect appeal decisions
 - Lead client eligibility appeal hearings using proper legal procedures, ensuring fairness and due process
 - Share case-related data and performance metrics with the Eligibility Cases Manager when requested.
 - Draft and issue legally supportable state fair hearing decisions in accordance with all deadlines.
 - Follow all established procedures of the Appeals Division
 - Use the Appeals Information Management System (AIMS) confidently to:
 - Attach hearing recordings
 - Upload final decisions and exhibit packets
 - Handle decision submissions, including resubmission requests
 - Ensure decisions are released on time so they can be mailed by the print vendor before the deadline
 - Apply laws, rules, regulations, and policies to make fair and well-reasoned written decisions based on facts and legal conclusions
 - Submit decisions to the Quality Assurance Team within required timeframes, focusing on meeting federal deadlines
 - Make sure all decisions are released in AIMS before their due dates
 - Share performance data and case metrics with the Eligibility Cases Manager when requested
 - Collaborate with Appeals Division team members.
 - Build productive working relationships with peers and work collaboratively to manage the flow of appeals
 - Assist with increased workload volume across teams, as requested
 - Complete assigned tasks and projects in a timely manner
 - Communicate effectively both orally and in writing with various staff members as it relates to assigned tasks and projects
 - Assist with training, as requested, to ensure continuity of operations
 - Immediately escalate issues between peers to management to ensure that an effective resolution can be reached in a timely manner
 
  
 
 
Special Assignments:
 
  
 - Special assignments are made at the request of the Eligibility Cases Manager, General Operations Manager, and Division Director.
 - Satisfactory completion of assignments within timeframes established by the Eligibility Cases Manager, General Operations Manager, and Division Director.
 
  
 
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