About This Role
Serving as the Medical Hearing Officer within the Appeals Division involves preparing for and conducting client medical appeal hearings. The role suits a candidate who can independently manage a caseload and render written appeal decisions at the highest administrative level, applying knowledge of relevant laws and regulations.
Responsibilities
- Review appeal requests, case documents, and other appropriate evidence to prepare for and conduct client medical appeal hearings
- Render written appeal decisions at the highest administrative level in accordance with fair hearing principles and within established timeframes
- Apply knowledge of laws, rules, and regulations in the decision process to independently render decisions based on findings of fact and conclusions of law
- Apply knowledge of administrative procedures for conducting hearings, due process standards, and legal research methods
- Conduct legal research
- Engage in thorough, accurate, and objective analysis and evaluation of facts, evidence, and law in order to make legally sound and defensible recommendations and judgments
- Independently manage a caseload to ensure timely compliance with deadlines
- Provide excellent customer service, treating everyone who interacts with the Division with respect and dignity
- Ensure every appellant receives full due process
- Support a collaborative and positive work environment
- Produce a quality work product
Requirements
- Experience independently managing a caseload to meet established time frames
- Considerable work-related experience applying rules to facts to reach logical, legally supportable conclusions
- Knowledge of administrative law and/or appeals procedures
- Considerable knowledge of legal research methodologies, including computerized legal research
- Considerable experience with technology, including MS Office
- Considerable experience interpreting, applying, and analyzing federal and state complex laws, regulations, policies, or case law
- Experience in meeting deadlines
- Experience with internal/external stakeholders
- Considerable experience in legal analysis and legal writing
Nice to have:
- Admission to the Virginia State Bar in good standing
- Experience drafting appeal decisions
Important Details
- Application deadline: Oct 13 2026 - 23:55 EDT
- In-office requirements, including in-person hearings
About the Company
The Department of Medical Assistance Services (DMAS) works to improve the health and well-being of Virginians through access to high-quality health care coverage.