Fair Hearing Specialist

Overview

Provide superior customer service to members who are in disagreement with Medicaid or Vermont Health Connect health eligibility determinations. The Health Care Appeals unit at the Department of Vermont Health Access (DVHA) is looking for a Fair Hearing Specialist (FHS) to fill this rewarding role. Have the work/life balance you need with a Monday-Friday schedule and a supportive hybrid work environment. Eleven paid state holidays, in addition to a robust benefits package.

The Fair Hearing Specialist position has the following responsibilities:
· Conduct detailed review of cases brought by members who are in disagreement with a Medicaid or Vermont Health Connect healthcare eligibility determination. 
· Track changes to policies and rules.
· Correct errors in the system and in some instances outreach customers to confirm disappointing decisions. 
· work closely with the Assistant Attorney General's office, who represent the department in hearings. 
· Manage conflicting priorities.
· Meet deadlines and provide superior customer service under difficult circumstances.
· Multi-task as needed.
 
Mission:
The Department of Vermont Health Access (DVHA)'s mission is to improve Vermonters' health and well-being by providing access to high-quality, cost-effective health care. We have identified three priorities that support our mission: Advancing value-based payments, modernizing information technology infrastructure, and operational performance improvement. Our department commits to executing our responsibilities and priorities while adhering to three core values: Transparency, Integrity and Service.

Diversity, Equity, and Inclusion:
As part of our values of transparency, integrity, and service, we are committed to supporting diversity, equity, inclusion, and accessibility as part of our person-centered culture. We actively celebrate our colleagues' and future colleagues' different abilities, racial identity, sexual orientation, ethnicity, age, and gender. Everyone is welcome and supported here.

Our State:
Vermont is a "small but mighty" state. We are ranked as one of the top 10 states to raise a family in 2022. We are nationwide leaders for progressive social and educational policies.  We are in Northern New England, 1.5 hours from Montreal and 3.5 hours from Boston. We have beautiful Lake Champlain, the Green Mountains, and year-round outdoor activities. 
 
Telework:
The Department of Vermont Health Access (DVHA) supports a hybrid work environment. Upon hire, employees work with their supervisor to create a schedule that aligns with the business needs of the unit. We believe a hybrid work environment promotes autonomy and allows for increased flexibility and greater work/life balance.

Who May Apply

This position, Fair Hearing Specialist (Job Requisition #53106), is open to all State employees and external applicants.
If you would like more information about this position, please contact dani.delong@vermont.gov
Resumes will not be accepted via e-mail.  You must apply online to be considered.
Please note that multiple positions in the same work location may be filled from this job posting.

 

AHS BACKGROUND CHECKS:  Candidates must pass any level of background investigation applicable to the position.  In accordance with AHS Policy 4.02, Hiring Standards, Vermont and/or national criminal record checks, as well as DMV and adult and child abuse registry checks, as appropriate to the position under recruitment, will be conducted on candidates, with the exception of those who are current classified state employees seeking transfer, promotion or demotion into an AHS classified position or are persons exercising re-employment (RIF) rights.

Environmental Factors

Duties are performed in a standard office setting. Some travel may be necessary, for which private transportation must be available. Stressful interaction with upset or emotional clients may occur. Staff workload may frequently be heavy. Work outside of typical business hours may be expected and incumbents might be required to appear in court, representing the State of Vermont.

Minimum Qualifications

Bachelor's degree AND one (1) or more years at or above a technical level role that includes research, customer service, review of healthcare services or similar field

OR

Associate's degree AND three (3) or more years at or above a technical level role that includes research, customer service, review of healthcare services or similar field.

OR

High School diploma or equivalent AND five (5) or more years at or above a technical level role that includes research, customer service, r