Administrative Hearings Staff Attorney A045 2013-03885
Location: Olympia, Washington
Description: State of Washington is currently seeking to employ Administrative Hearings Staff Attorney A045 2013-03885 right now, this position will be presented in Washington. More complete informations about this position opportunity please read the description below. The Health Care Authority is currently seeking a highly motivated individual for the position of Administr! ative Hearings Staff Attorney.
This recruitment is open until filled. Applications will be reviewed beginning April 12, 2013. The hiring manager reserves the right to close the recruitment at any time after the first review of applications.
The Health Care Authority (HCA) administers programs that provide health care insurance coverage to over 1.6 million Washington residents and 400,000 public employees, retirees and their dependents. HCA promotes health care access to the uninsured, under insured, and Tribes; it ensures that health technology and prescription drugs are safe and used effectively, and improve health and productivity of state employees, retirees, and their dependents. HCA administers Washington's Medicaid program which provides federal and state medical assistance to over 1.2 million of Washington’s most vulnerable individuals.
The Division of Legal and Administrative Services’ Office of Hearings and Appeals (OHA) supports the Healt! h Care Authority (HCA) in administrative hearings and appeals.! The OHA is managed by HCA’s Appeals Administrator who reports directly to the Chief Administrative Officer (CAO) within the Division of Legal and Administrative Services (LAS). The Administrative Hearings Staff Attorneys report to the Appeals Administrator.
The Olympia office is located in downtown Olympia, within walking distance of shops, restaurants, bus lines and less than two miles from the freeway.
For more about our agency and its mission, visit our Web site at http://www.hca.wa.gov/ .
Duties:
The Administrative Hearings Staff Attorney represents HCA at quasi-judicial administrative hearings before Administrative Law Judges (ALJ) and the HCA Board of Appeals (BOA) in a wide variety of case types ranging from client appeals of medical service denials to large dollar provider overpayment appeals.
Additionally, the Staff Attorney provides expert advice based on Medicaid subject matter expertise on the development, review, and! revision of applicable provisions of the Washington Administrative Code and program development, and participates in the creation of policies and procedures ensuring that HCA’s programs provide the due process to the citizens of the State of Washington, thus reducing HCA’s risk of costly litigation, adverse public reaction, and protects against the loss of state and federal funds.
The Administrative Hearings Staff Attorney keeps abreast of frequent and complicated changes in Medicaid law. The staff attorney position ensures HCA has adequate resources to support the hearings workload. The staff attorney also helps HCA avoid hearing delays, violations of clients’ due process rights, payments for services consumed by ineligible clients, negative health consequences for clients, and lost opportunities to collect overpayments.
Represent HCA in recipient fee-for-service (FFS) medical assistance cases, enrollee managed care organization (MCO) appeals, and provi! der overpayment appeals before the Office of Administrative Hearings (O! AH) and the HCA Board of Appeals (BOA).
Independently manage substantial caseloads for HCA’s state-wide administrative hearings involving client medical services and provider overpayment. Advise and collaborate with program staff about medical program policies and compliance with the Revised Code of Washington (RCW), the Washington Administrative Code (WAC), the Washington Administrative Procedures Act (APA), and federal Medicaid law.
Responsible for evaluation, planning, policy promulgation, and consultative services to clients, medical providers and other professionals in the community and/or HCA regarding program administration. Specifically includes reviewing and recommending action on exception to rule requests in the context of HCA Washington Administrative Code provisions.
Review cases and determine, in conjunction with involved program managers, whether findings require review by the utilization review team and/or the executive leadership group.
Pr! epare summaries of medical policy issues arising from case development for presentation to upper management. Coordinate case development with other agencies, and make referrals to other agencies for appropriate administrative action.
Research and interpret complex legal and medical issues, and concisely convey this information to multi-level and diverse audiences via written memoranda and other media.
Provide technical and consultative services to providers, recipients, legislative staff, legal aid professionals, and others regarding HCA programs.
Provide training for HCA as needed regarding HCA administrative hearing issues, and consult with assigned Assistant Attorney General (AAG) when necessary.
Independently prepare and present FFS/MCO and provider overpayment cases at hearing or on appeal, including: reviewing assigned cases and correctly identifying the pertinent legal issues; conducting legal research; participating in pre-hearing consultations with ! recipients or their representatives, program staff, and OAH staff; gath! ering evidence and providing discovery; resolving cases prior to hearing, when appropriate; drafting motions, pleadings, memoranda, requests for review and responses; thoroughly preparing program/expert witnesses; vigorously representing HCA at hearing and on appeal; and closing cases.
Evaluate and analyze complex issues arising in administrative hearings that may encumber HCA’s attempts to carry out the Legislature’s intent to recoup overpayments from providers who have inappropriately billed for services or provided inappropriate or inadequate quality of care.
Identify issues arising in administrative hearings that may lead to potential litigation and adverse public reaction; and research state and federal law and case law to determine possible problems that may lead to potential litigation and to determine possible solutions to avoid litigation.
Evaluate, analyze, and recommend workable, sound and effective recommendations related to the Washington Admini! strative Code (WAC) and HCA policies; and initiate and collaborate with program staff in reviewing and revising the WACs to conform with HCA policy and federal and state law.
Develop and proactively enhance familiarity, understanding and expertise with case law, statutes, and regulations governing Medicaid law, administrative law, contract law, and the rules of evidence.
Maintain appropriate levels of confidentiality and compliance with applicable statutes, rules, HCA policies, and program procedures.
Respond promptly to external and internal customers using effective listening and interpersonal communication skills.
Work independently, diligently, and constructively, managing not only a substantial caseload but also the demands of internal/external clients as well as complex WAC workgroup research assignments and competing stakeholders in the rulemaking process, and meet timelines.
Establish and maintain effective working relationships, and treat others! with respect and courtesy.
Help capture and maintain data integrit! y through accurate and timely reporting and assists in the preparation of management reports.
Qualifications:
Required Education, Experience, and Competencies
Advanced level of legal expertise including graduation from an accredited law school.
Active membership and good standing in the Washington State Bar Association (WSBA).
Two years’ experience in administrative hearings under the Washington Administrative Procedures Act, in cases in front State court or federal court, or other equivalent legal experience.
Ability to independently develop effective legal arguments and case management practices to ensure successful outcomes for HCA hearings.
Capacity to advise program staff and assist with rule and policy development to help ensure long-term success of HCA programs.
Knowledge of and experience with the rules of evidence, discovery, and civil procedure.
Basic knowledge of information technology and skills in working with s! ystems and software, including proficiency with Microsoft Office applications.
Knowledge of Medicaid, Basic Health, and PEBB regulations and programs. Preferred/Desired Education, Experience, and Competencies.
Knowledge of healthcare delivery methods and trends.
Knowledge of National Healthcare Reform in state and in federal government.
Experience representing state agencies or clients in administrative hearings related to the Medicaid program.
Excellent oral and written communication skills are desired. Knowledge and skills in litigation, negotiation, mediation, and conflict resolution. Knowledge of ethics and standards of practice. Good public speaking, diplomacy, negotiating, problem solving, and consultation skills. Demonstrates personal accountability.
Demonstrated performance at an increasingly challenging level in the field of law.
Supplemental Information:
Special Note: Persons under final consideration for ini! tial appointment within the agency are subject to a background check.
The starting salary for this position is $56,208 per year. Salary is negotiable depending on the successful candidate's qualifications.
If this position is included in a Union Shop, employees will be required to become members within thirty (30) days of employment.
Please note that failure to follow instructions will lead to disqualification. If you have questions about the process, or need assistance, please contact the recruiter listed below before the posting closes.
To apply for this position you will need to complete your profile at careers.wa.gov and you MUST attach the following to your profile before completing the on-line application:
1. Cover Letter describing how you meet the qualifications of this position.
2. Current resume.
3. List of three professional references.
If you are chosen to move forward in the selection process you may be asked to provide a writing sample that should be 3-5 pages of ! legal pleading exceprts of a fact section and a legal argument section. The writing sample must be in 12 font and double spaced with one inch margins.
The State of Washington is an equal opportunity employer. Persons with a disability who need assistance in the application or testing process or those needing this announcement in an alternative format, may call (360) 725-1027. For questions about this recruitment email Tracy.Wynder@hca.wa.gov or call Tracy Wynder at (360) 725-1027.
**Please note: Legislature mandates require that employee salaries be reduced by 3% July 1, 2011 - June 29, 2013. Range and step remain the same, but rate of pay will be reduced by 3% during this time period.
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If you were eligible to this position, please give us your resume, with salary requirements and a resume to State of Washington.
Interested on this position, just click on the Apply button, you will be redirected to the official website
This position starts available on: Tue, 09 Apr 2013 00:50:38 GMT
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