This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/job/698795600. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
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 Associate Chief ALJs 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, and entitlements.
01/10/2023 to 01/24/2023
$195,000 - $195,000 per year
AL 2
1 vacancy in the following location:
No
Yes—as determined by the agency policy.
Occasional travel - You may be expected to travel for this position.
Yes— You may qualify for reimbursement of relocation expenses in accordance with agency policy.
Permanent
Full-time
Excepted
None
Yes
No
HHS-OMHA-ALJ-23-11789448
698795600
Current or former competitive service federal employees.
Current excepted service federal employees.
Current or former Federal Administrative Law Judges (ALJ) serving in the competitive or excepted service. The candidate selected for this position will be in the excepted service unless the candidate is currently an OMHA ALJ in the competitive service. In that situation, per OPM guidance, the candidate will remain in the competitive service.
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.
The Associate Chief ALJ plans, directs and coordinates the hearings activities for all cases coming under the jurisdiction of the field office.
Manages the maintenance of a control system to monitor status of all cases and provides statistical reports on the status of those cases. Charged with ensuring field office staff foster the continuous improvement of business processes and workflows and enhances the use of enabling technologies to operate successfully in "a fully electronic, paperless field office."
Assures that hearing proceedings conducted by the field office are in accord with procedural requirements of the Administrative Procedure Act and applicable Federal laws and HHS regulations.
Monitors the status of pending cases and recommends reasonable standards of quality, output, and productivity to assure the timely and expeditious processing of those cases to meet the Part A and B 90-day decisional timeframes.
Presides at hearings in some of the most difficult and controversial proceedings; develops the record in such proceedings from oral testimony and documentary evidence; independently studies and analyzes the evidence; and prepares decisions containing findings of fact, supporting rationale, conclusions of law, and resolution of the appeal.
Provides technical procedural guidance to ALJs and to other field office employees.
1. Security and Background Requirements: 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.
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. The selectee will be required to submit an Executive Personnel Public Financial Disclosure Report, SF-278, in accordance with the Ethics in Government Act of 1978, prior to the effective date of appointment and annually thereafter.
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. SELECTIVE SERVICE: MALE APPLICANTS BORN AFTER 12/31/1959 must certify prior to job offer that they have registered with the Selective Service System or are exempt from having to do so under Selective Service law.
14. The candidate selected for this position will be in the excepted service unless the candidate is currently an OMHA ALJ in the competitive service. In that situation, per OPM guidance, the candidate will remain in the competitive service.
This job does not have an education qualification requirement.
Reasonable Accommodation: This agency provides reasonable accommodation to applicants with disabilities. If you need a reasonable accommodation for any part of the application and hiring process, please see Agency Contact Information for whom to contact for more info. The decision on granting reasonable accommodation will be made on a case-by-case basis. You must contact the HR contact on the vacancy announcement at least three business days before the closing date of this announcement to receive assistance.
For more information on disability employment, please visit https://www.opm.gov/policy-data-oversight/disability-employment/
Beginning January 1, 2010, agencies must seek prior approval from OPM before they can appoint a current or recent political appointee to a competitive or non-political excepted service position at any level under the provisions of title 5, United States Code. If you are currently or have been within the last 5 years, a political Schedule A, Schedule C, or Non-career SES employee in the executive branch, you MUST disclose that to the Human Resources Office.
Veterans' Preference: There is no formal rating system for applying veterans' preference to ALJ appointments in the excepted service; however the Department of Health and Human Services considers veterans' preference eligibility as a positive factor in ALJ hiring. Applicants eligible for veterans' preference must include that information in their resume and attach supporting documentation (e.g. the DD-214 Certificate of Release or Discharge from Active Duty (Member 4 copy) and other supporting documentation) to their submissions. Although the "point" system is not used, per se, applicants eligible to claim 10 point preference must submit Standard Form SF-15, Application for 10 point Veteran Preference, and submit the supporting documentation required for the specific type of preference claimed (visit the OPM website, www.opm.gov/forms/pdf_fill/SF15.pdf for a copy of SF-15 which lists the types of 10-point preferences and the required supporting documents). Applicants should note that SF-15 requires supporting documentation associated with service-connected disabilities or receipt of non-service-connected disability pensions to be dated 1991 or later except in the case of service members submitting official statement or retirement orders from a branch of the Armed Forces showing that his or her retirement was due to a permanent service-connected disability or that he/she was transferred to the permanent disability retired list (the statement or retirement orders must indicate that the disability is 1-% or more).
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
You will be evaluated for this job based on how well you meet the qualifications above.
OMHA will evaluate applicants' qualifications based on the Mandatory and Desirable qualifications.
Do not overstate or understate your level of experience and capability. You should be aware that your submissions are subject to evaluation and verification. Later steps in the selection process may be used to verify your stated level of experience and capability. If a determination is made that you have rated yourself higher than is supported by your resume or background investigation you will be assigned a rating commensurate to your described experience. Deliberate attempts to falsify information may be grounds for not selecting you. If you are found to be among the top candidates, you will be referred to the selecting official for employment consideration and interview.
To preview the assessment questionnaire, click the following link:https://apply.usastaffing.gov/ViewQuestionnaire/11789448
NOTE: If you submit a resume but no questionnaire, you cannot be considered for the position. If you submit a questionnaire but no resume, you cannot be considered for the position. Your application will be appropriately documented, and you will be removed from further competition against this announcement.
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.
Please ensure you read the requirements of this vacancy announcement in its entirety. Failure to submit one of the requirements of this announcement will result in an ineligible rating.
The following information must be received by 11:59 pm on the closing date of the announcement.
To apply for this position, you must complete the occupational questionnaire and submit the documentation specified in the Required Documents section above.
*To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USAJOBS resume and/or other supporting documents and complete the occupational questionnaire.
*Click the Submit My Answers button to submit your application package.
*It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date. Failure to provide all required documents and information requested by the closing date will result in your application not being considered.
To verify your application is complete, log into your USAJOBS account at https://my.usajobs.gov/Account/Login, select the Application Status link, and then select the more information link for this position. The Details page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process.
To return to an incomplete application, log into your USAJOBS account at https://my.usajobs.gov/Account/Login and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USAJOBS account, or your application will be incomplete.
The complete Application Package must be submitted by 11:59 PM (EST) on 01/24/2023.
NOTE: If you have questions concerning the application process please contact Rachel Place at 216-462-4055 or Jordan Skolnitsky at 571-777-2738.
Once the online questionnaire is received you will receive an acknowledgement email that your submission was successful. The best qualified candidates will be referred to the hiring manager for further consideration and possible interview. We expect to make a selection within 45 days of the closing date of this announcement.
You will receive notice via email or by mail, if no email address was provided by you during the application process, once this process is completed (generally 4-6 weeks).
HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
Please ensure you read the requirements of this vacancy announcement in its entirety. Failure to submit one of the requirements of this announcement will result in an ineligible rating.
The following information must be received by 11:59 pm on the closing date of the announcement.
To apply for this position, you must complete the occupational questionnaire and submit the documentation specified in the Required Documents section above.
*To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USAJOBS resume and/or other supporting documents and complete the occupational questionnaire.
*Click the Submit My Answers button to submit your application package.
*It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date. Failure to provide all required documents and information requested by the closing date will result in your application not being considered.
To verify your application is complete, log into your USAJOBS account at https://my.usajobs.gov/Account/Login, select the Application Status link, and then select the more information link for this position. The Details page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process.
To return to an incomplete application, log into your USAJOBS account at https://my.usajobs.gov/Account/Login and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USAJOBS account, or your application will be incomplete.
The complete Application Package must be submitted by 11:59 PM (EST) on 01/24/2023.
NOTE: If you have questions concerning the application process please contact Rachel Place at 216-462-4055 or Jordan Skolnitsky at 571-777-2738.
Once the online questionnaire is received you will receive an acknowledgement email that your submission was successful. The best qualified candidates will be referred to the hiring manager for further consideration and possible interview. We expect to make a selection within 45 days of the closing date of this announcement.
You will receive notice via email or by mail, if no email address was provided by you during the application process, once this process is completed (generally 4-6 weeks).
HHS has a critical preparedness and response mission: HHS protects the American people from health threats, researches emerging diseases, and mobilizes public health programs with domestic and international partners. In support of this mission, HHS offers its employees the opportunity to volunteer to become Federal Civilian Detailees and contribute their unique skills through voluntary temporary assignments to humanitarian emergencies or Departmental priorities countering new and emerging health, safety, and security threats.
The Federal hiring process is set up to be fair and transparent. Please read the following guidance.
This job originated on www.usajobs.gov. For the full announcement and to apply, visit www.usajobs.gov/job/698795600. Only resumes submitted according to the instructions on the job announcement listed at www.usajobs.gov will be considered.
Learn more about
Come be a part of an office within the Department of Health and Human Services (HHS) focused on providing exceptional and quality service. The Office of Medicare Hearings and Appeals (OMHA), a component of HHS, is looking for an innovative, enthusiastic, and experienced Administrative Law Judge (ALJ) to support OMHA's Phoenix Field Office. Join us today!
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 Associate Chief ALJs and their staff in the adjudication of Medicare appeals.