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Supervisory Adminstrative Law Judge

Expired Job

Department Of Health And Human Services Irvine , CA 92606

Posted 3 months ago

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HelpDuties Summary

"OMHA is a responsive forum for fair, credible, and timely decision-making through an accomplished, innovative, and resilient workforce. Each employee makes a difference by contributing to shaping American healthcare." OMHA nationally administers the third level of appeals for the Medicare program. The Supervisory Administrative Law Judges (ALJs) within OMHA issue the decision of the Secretary on appeals involving Medicare Parts A, B, C, and D, entitlements and premium rate increases.

Learn more about this agency

Responsibilities

OMHA nationally administers the third level of appeals for the Medicare program. The Supervisory Administrative Law Judges (ALJs) within OMHA issue the decision of the Secretary (except for decisions reviewed by the Medicare Appeals Council) on appeals involving Medicare Parts A, B, C, and D, entitlements and premium rate increases.

OMHA provides the basic mechanisms through which individuals and organizations dissatisfied with Medicare determinations affecting their rights in the Medicare program may obtain a hearing under the Social Security Act on these determinations. The OMHA offices incorporate state of the art video-teleconferencing and audio-teleconferencing technologies, automated data reporting and case management systems, and a variety of other office automation and IT technologies to aide Supervisory ALJs and their staff in the adjudication of Medicare appeals.

In conformity with the Administrative Procedures Act, 5 U.S.C. 551, et. seq. as well as the Medicare provisions of the Social Security Act and their attendant regulations, OMHA ALJs make pre-hearing rulings, preside over formal hearings, decide post-hearing matters, and issue written decisions under authority delegated by the Secretary of HHS. Issues on appeal arise from Medicare coverage and payment determinations made by Medicare contractors, Medicare Advantage Organizations (MAOs), or Part D Plan Sponsors (PDPSs), and determinations related to Medicare eligibility and entitlement, and income-related premium surcharges made by the Social Security Administration (SSA) under sections 1869, 1155, 1876(c)(5)(B), 1852(g)(5), and 1860D-4(h) of the Social Security Act. The appeals are frequently complex, require the interpretation and application of federal statutes, regulations, and program policy, may be contested, and are subject to demanding time constraints.

Supervisory ALJs are assigned cases of varying difficulty on a rotational basis and it is the responsibility of the Supervisory ALJ to hold Administrative Procedure Act hearings as appropriate and produce legally and technically accurate decisions on all cases within applicable statutes and regulations. If selected to serve as a Supervisory ALJ for OMHA, you will supervise the day-to-day opertaions of a hearing team in an OMHA field office. Supervisory ALJs are also responsible for operating in a fully electronic, state of the art hearing office environment.

Travel Required

Occasional travel - You may be expected to travel for this position.

Supervisory status

Yes

Promotion Potential
3

  • Job family (Series)
    0935 Administrative Law Judge

Similar jobs

  • Adjudicators, Administrative Law

  • Administrative Law Adjudicators

  • Administrative Law Judges

  • Judges, Administrative Law

  • Requirements

HelpRequirements Conditions of Employment
1.Security and Background

Requirements:
If not previously completed, a background security investigation will be required for all appointees. Appointment will be subject to the applicant's successful completion of a background security investigation and favorable adjudication. Failure to successfully meet these requirements may be grounds for appropriate personnel action. In addition, if hired, a background security reinvestigation or supplemental investigation may be required at a later time. Applicants are also advised that all information concerning qualifications is subject to investigation. False representation may be grounds for non-consideration, non-selection and/or appropriate disciplinary action.
2.E-Verify: If you are selected for this position, the documentation that you present for purposes of completing the Department of Homeland Security (DHS) Form I-9 will be verified through the DHS "E-Verify" System. Federal law requires DHS to use the E-Verify System to verify employment eligibility of all new hires, and as a condition of continued employment obligates the new hire to take affirmative steps to resolve any discrepancies identified by the system. The U.S. Department of Health and Human Services is an E-Verify Participant.
3.Direct Deposit: All Federal employees are required to have Federal salary payments made by direct deposit to a financial institution of their choosing.
4.All Mandatory Qualification requirements must be met by the closing date of the announcement.
5.A financial disclosure statement is required.
6.Travel, transportation, and relocation expenses may be paid: Yes
7.Bargaining Unit Position: No
8.Drug Screening Required: No
9.Recruitment incentives may be authorized: No
10. Student loan repayment incentive authorized:No
11. Annual leave for non-federal service authorized: No
12. U.S. Citizenship required
13. This is an excepted service position.

Qualifications

MANDATORY QUALIFICATION: Candidates must currently hold an Administrative Law Judge (ALJ) position, at the AL-3 level or above.

Desirable Qualifications (DQs): The Expression of Interest, which is one of the required documents for this vacancy announcement, should be formatted so that each desirable qualification is individually addressed.

  • Demonstrated ability to adjudicate a high volume of cases ranging from simple disputes to highly complex contested cases in a timely fashion.

  • Demonstrated ability to understand, analyze, decide and communicate difficult and complex technical, legal and factual issues.

  • Demonstrated ability to communicate orally in a clear and precise matter while exhibiting appropriate judicial temperament.

  • Demonstrated ability to produce a comprehensive legally and technically defensible agency decision involving complex technical, legal and factual issues written in a clear and precise manner.

  • Demonstrated ability to lead and supervise staff in an effective manner in order to accomplish stated goals.

  • Demonstrated knowledge of Medicare issues is helpful.

All Mandatory Qualification requirements must be met by the closing date of this announcement.

Education

This job does not have an education qualification requirement.



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Supervisory Adminstrative Law Judge

Expired Job

Department Of Health And Human Services