Administrative Hearing Officer
(HCFA Administrative Judge)
TennCare is Tennessee's managed care Medicaid program that provides health insurance coverage to certain groups of low-income individuals such as pregnant women, children, caretaker relatives of young children, older adults, and adults with physical disabilities. TennCare provides coverage for approximately 1.3 million Tennesseans and operates with an annual budget of approximately $12 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS).
WHY WORK AT TENNCARE?
TennCare’s mission is to improve the lives of Tennesseans by providing high-quality cost-effective care. To fulfill that purpose, we equip each employee for active participation and empower teams to communicate and work collaboratively to improve organizational processes in order to make a difference in the lives our members. Because of the positive impact TennCare has on the lives of the most vulnerable Tennesseans, TennCare employees report that their work provides them with a sense of meaning, purpose, and accomplishment. TennCare leadership understands that employees are our most valuable resource and ensures professional and leadership development are a priority for the agency.
JOB AND DEPARTMENTAL OVERVIEW
The Division of TennCare, Tennessee Department of Finance and Administration has an open attorney position for an Administrative Hearing Officer in the Eligibility Hearing Officer Unit within the Office of the General Counsel (OGC). The Unit consists of 22 licensed attorneys who preside as administrative hearing officers over eligibility appeals and 3 supervisors.
The Administrative Hearing Officers are an impartial group that preside over TennCare eligibility hearings in accordance with the Uniform Administrative Procedures Act (UAPA) and write Orders based upon their legal conclusions and findings of fact.
- Administrative Hearing Officers (AHOs) must demonstrate a working knowledge of the Uniform Administrative Procedures Act, the Rules of Civil Procedure, the Rules of Evidence and the Code of Federal Regulations.
- AHOs will determine the issue(s) to be presented for each hearing, rule on objections, motions and the admissibility of evidence; issue subpoenas and administer oaths in preparation for hearings.
- At times, AHOs will examine witnesses when necessary to gain all requisite facts.
- AHOs will research and analyze applicable regulations, statutes, laws and policies to determine conclusions of law.
- AHOs will identify the findings of fact based upon the testimony and evidence proffered at the hearing and set forth those facts clearly in an Initial Order.
- AHOs will respond to Petitions for Reconsideration of the Initial Order within the specified time frame.
- This position is all about process and due process. AHOs must understand the importance of ensuring that TennCare applicants are dealt with fairly and that their appeals are handled within the appropriate timeframes.
- Hearing locations will vary resulting in frequently changing environmental conditions that may at times be loud and uncomfortable. AHOs will need to interact with individuals and handle conflict situations. The job requires making unsupervised decisions that affect other people, financial resources, and/or the image and reputation of the organization.
- AHOs must be punctual, have regular work attendance, and be able to meet strict deadlines.
- MINIMUM QUALIFICATIONS
- Applicants should have a current, valid license to practice law in Tennessee and a minimum of 2 years of relevant experience.
- Strong oral and written communication skills required.
- Must be able to sit for long periods during the work day, listening to evidence and verbally communicating for several hours a day, and, on occasion, driving long distances to different hearing locations
- Must have the ability to accurately read documents for long periods (i.e. evidence and legal research), frequently compose exact legal documents, and be able to complex problem solve.
- Must be able to operate office computer systems and telephone systems.
- DESIRABLE QUALIFICATIONS
- Experience with administrative proceedings is strongly desired.
- Familiarity with Medicaid or other government benefit programs will be helpful.
- JOB LOCATION: Nashville, Tennessee
- HOW TO APPLY: Qualified candidates should send their resumes along with a cover letter to HCFA.OGC@tn.gov by June 14, 2019.
Position Status: Executive Service
Pursuant to the State of Tennessee’s Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State’s policy to provide an environment free of discrimination and harassment of an individual because of that person’s race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran’s status or any other category protected by state and/or federal civil rights laws.