Health Hearing Examiner -63556

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Review Vacancy

Date Posted 06/18/24

Applications Due07/02/24

Vacancy ID161228

• Basics

• Schedule

• Location

• Job Specifics

• Contact

NY HELPNo

AgencyHealth, Department of

TitleHealth Hearing Examiner -63556

Occupational CategoryLegal

Salary GradeNS

Bargaining UnitM/C - Management / Confidential (Unrepresented)

Salary RangeFrom $123793 to $156224 Annually

Employment Type Full-Time

Appointment Type Temporary

Jurisdictional Class Exempt Class

Travel Percentage 0%

Workweek Mon-Fri

Hours Per Week 37.5

Workday

From 8 AM

To 4 PM

Flextime allowed? No

Mandatory overtime? No

Compressed workweek allowed? No

Telecommuting allowed? Yes

County Albany

Street Address Division of Legal Affairs / Office of Marketplace Counsel

14 Corporate Woods Blvd.

City Albany

StateNY

Zip Code12211

Minimum Qualifications Member in good standing of the New York State Bar and

seven (7) years of management experience in a large administrative legal division operation or as a managing partner in a large law firm, with a substantial part of that experience devoted to addressing New York City's Human Resources Administration issues. This experience must include the administration of hearings.

Preferred Qualifications: Eight (8) years of post-Bar legal experience in trial of issues in courts of record or adversarial proceedings, quasi-judicial in nature, before a government agency with five (5) of those years in program management and/or supervision of attorneys. Experience working as counsel for public health insurance programs and/or with a legal services organization specializing in health law.

Duties Description Reporting to the Director of the Office of Marketplace Counsel, the incumbent of this position will manage a staff of attorneys and administrative employees to ensure that timely appeals hearings are available to individuals receiving eligibility determinations from the Marketplace. The incumbent will provide guidance on Customer Service procedures for receiving and processing individual requests for appeal.

Additional duties shall include but not be limited to: Oversee the Marketplace appeals program or a major portion of that operation by supervising staff, acquiring resources and ensuring that regulatory timeframes and production standards are met. Directly supervise a Principal Hearing Officer and several Supervising Hearing Officers.

Participate in administrative activities including projected staffing requirements based on work load and any case backlog, and facility requirements to support the timely and effective scheduling of hearings and issuance of decisions. Establish and maintain policies and procedures to ensure the most efficient processing of requests for hearings, including requests for expedited hearings. Ensure the timely and effective scheduling of hearings and disposition of cases and that Hearing Officers receive essential support.

Review hearing decisions to ensure that law, policies and procedures are being correctly applied. Review and take final action regarding recommendations on requests for reconsideration of hearing decisions to ensure that decisions are correctly decided; and amend or reopen hearing records as appropriate. Review pertinent court rulings and determine their effect on hearing policies and procedures.

Modify policies and procedures to comply with court decisions, statutory amendments and regulatory changes. Identify training needs for hearing officers and support staff and establish a training program to prepare hearing officers to conduct hearings regarding the individual insurance programs available through the Marketplace; approve updates to the training program as necessary. Inform staff of changes in statutes, regulations, policies, and court decisions that affect the hearing program.

Review and comment on proposed legislation affecting the hearing program. Oversee the response to claims of non-compliance with hearing decisions and ensure proper resolution of complaints. Assist with the external program integrity audit of the Marketplace appeals program and audits by State and federal agencies regarding the appeals program and/or the individual insurance programs available through the Marketplace.

Maintain data on an ongoing basis regarding the appeals program, including appeal requests, hearings, and the status of individual appeals. Assist in fielding inquiries and addressing complaints from appellants, representatives, or other governmental agencies concerning the hearing process. Act as a liaison with counsel's office regarding hearing decisions that are appealed to the courts.

Provide expert legal advice and opinions to management and staff on hearing matters and customer service staff regarding the appeal process. Draft reports on hearing activities. Prepare or assist in compiling the budget for the hearings operation.

Represent the agency in meetings with legal advocacy and other interest groups; and provide information concerning the operation and practices of the appeals program. Serve as the point of contact for the appeals program on inter-agency projects involving IT systems or other agency initiatives. Perform other duties to ensure the proper functioning of the Marketplace appeals unit and maintains appropriate communications.

Additional Comments Benefits of Working for NYS

Generous benefits package, worth 65% of salary, including:

Holiday & Paid Time Off

• Thirteen (13) paid holidays annually

• Up to Thirteen (13) days of paid vacation leave annually

• Up to Five (5) days of paid personal leave annually

• Up to Thirteen (13) days of paid sick leave annually for PEF/CSEA

• Up to Eight (8) days of paid sick leave annually for M/C

• Up to three (3) days of professional leave annually to participate in professional development

Health Care Benefits

• Eligible employees and dependents can pick from a variety of affordable health insurance programs

• Family dental and vision benefits at no additional cost

Additional Benefits

• New York State Employees' Retirement System (ERS) Membership

• NYS Deferred Compensation

• Access to NY 529 and NY ABLE College Savings Programs, as well as U.S. Savings Bonds

• Public Service Loan Forgiveness (PSLF)

• And many more..

For more information on the NYS Department of Health's Mission, Vision, Values and Strategic Plan, please visit: https://health.ny.gov/commissioner/index.htm

Some positions may require additional credentials or a background check to verify your identity.

Name Human Resources Management Group, EM/HE/63556

Telephone 5184861812

Fax (518) 473-3395

Email Address resume@health.ny.gov

Address

Street Rm 2217, Corning Tower Building, Empire State Plaza

City Albany

State NY

Zip Code 12237

Notes on Applying Please submit your resume and cover letter, preferably in PDF format, by email to resume@health.ny.gov, with Reference EM/HE/63556 included in the subject line or by mail to Human Resources Management Group, EM/HE/63556, Rm 2217, Corning Tower Building, Empire State Plaza, Albany, NY 12237-0012, or by fax to (518) 473-3395. Failure to include the required information may result in your resume not being considered for this position.