The Office of Medicare Hearings and Appeals (OMHA) administers the third level of appeals nationwide for the Medicare program, ensuring that beneficiaries, providers, and suppliers have access to an independent forum and an opportunity for a hearing. OMHA's mission is to be a responsible 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 health care.

Duties

Please note: The selectee will continue to sit in their current office location. Incumbent serves as a Senior Attorney Advisor in the Appeals Policy and Operations Division (APOD) performing the following duties: Provides expert technical legal advice, research, and guidance in the formulation, development, and implementation of OMHA policies related to appeal processing, agency guidance, and certain operational procedures. Handles novel issues in application and interpretation of laws and regulations governing Medicare coverage and payment claims under Part A, B, C, and D, as well as IRMAA and entitlement claims and disputes of Part B and D premium surcharges. Works on highly complex problems, proposed legislation, or proposed changes in Medicare policies or regulations that may affect OMHA appeals processing, operations, and/or the adjudication process OMHA administers. Researches statutes, legislative history, public policy implications, precedent cases, applicable regulations, and procedures; and demonstrates the ability to convey clear legal analysis. Reviews and comments on proposals for changes to new or existing adjudication policies and procedures affecting OMHA appeal processing. Contributes to developing, reviewing, and delivering agency-wide presentations. Coordinates on data analytics impacting OMHA adjudicative policies, agency goals, operational matters, data integrity, and workload management. Produces well-researched and well-written memoranda. Communicates effectively with OMHA managers, OMHA staff, Medicare stakeholders, and external entities. Serves as a liaison between APOD and other divisions within Headquarters.

Requirements

Qualifications

Minimum Qualification Criteria for Attorneys: EDUCATION: Successful completion of a full course of study in a school of law accredited by the American Bar Association through which you have attained the first professional law degree, i.e. LLB, or J.D. NOTE: A transcript is required to substantiate possession of the required and claimed education. Unofficial transcripts (including screen-prints from your school's web portal) are acceptable for initial application; however, the unofficial transcript must show: your name the name of the educational institution the degree awarded the conferred/awarded date Self-prepared transcripts will not be accepted. Official transcripts are required prior to appointment. BAR MEMBERSHIP: All attorney positions require current active bar membership. Admission to the bar of any State, territory, Commonwealth of Puerto Rico, District of Columbia, or Federal Court is acceptable. Employees must maintain active bar membership while employed as an attorney with HHS/OMHA. NOTE: You MUST provide proof that you are authorized to practice law. Failure to provide proof will result in an ineligible rating. Such proof can include: An active bar card that shows the current year or an expiration date outside of the closing date of the announcement. If the card only shows a previous year (example: 2023, you must submit additional documentation. A screen print from a bar website that reflects you are an active member of the bar. The screen print must make clear what month, date, and year the screen print was taken. A letter/certificate from the bar certifying that you are licensed and authorized to practice law. The letter must be dated within one year of the closing date of the announcement. Grade Specific Qualifications: GS-13: In addition to the minimum qualifications above for the GS-13 Senior Attorney Advisor position, candidates must have two (2) years of professional legal experience after admission to the bar commensurate with the duties of the position and at least one year of experience that is equivalent to the GS-12 grade level in the Federal service. Documenting experience: In accordance with Office of Personnel Management policy, federal employees are assumed to have gained experience by performing duties and responsibilities appropriate for their official series and grade level as described in their position description. Experience that would not normally be part of the employee's position is creditable, however, when documented by satisfactory evidence, such as a signed memorandum from the employee's supervisor or an SF-50 or SF-52 documenting an official detail or other official assignment. The documentation must indicate whether the duties were performed full time or, if part time, the "percentage of times" the other duties were performed. It is expected that this documentation is included in the employee's official personnel record. In order to receive credit for experience in your resume that is not within the official series and grade level of your official position, you must provide a copy of the appropriate documentation of such experience as indicated above. Experience refers to paid and unpaid experience, including volunteer work done through national Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to gain employment. You will receive credit for all qualifying experience, including volunteer experience. If such experience is on a part-time basis, you must provide the average number of hours worked per week as well as the beginning and ending dates of the experience so it can be fully credited.

Education

EDUCATION: Successful completion of a full course of study in a school of law accredited by the American Bar Association through which you have attained the first professional law degree, i.e. LLB, or J.D.

Foreign Education: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show that the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. For further information, visit: https://www2.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Contacts

• Address Office of Medicare Hearings and Appeals Presidential Tower 2550 South Clark Street Arlington, VA 22202 US
• Name: OMHA Human Resources Center
• Email: [email protected]