Deputy Chief Administrative Law Judge
Company: Office of the Secretary of Health and Human Servic
Posted on: May 3, 2021
"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. OMHA 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.
In conformity with the Administrative Procedure 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 DCALJ is accountable to the CALJ and provides
leadership and coordination of OMHA activities. Provides the
professional guidance and executive leadership necessary to assure
the thorough, yet most expeditious, processing of all Medicare
claims hearing requests filed with OMHA. Leads the OMHA day-to-day
operations and oversees the development of OMHA policies and
standard operating procedures. The DCALJ is accountable for the
organization's overall performance and sets the workforce's
expected performance level consistent with statutory timeframes and
other regulatory mandates. 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. Designs, develops, and
implements strategies that will maximize the effective use of human
resources, financial assets and technology to deliver quality
Medicare claims hearings. Maintains a work environment that is
safe, healthy, and culturally diverse. Ensures all employees are
provided with the tools and developmental opportunities to develop
their professional skills to contribute to the achievement of
OMHA's organizational goals and objectives. Provides executive
oversight for the direction of ALJ training. Serves as the agency's
most senior subject-matter-expert and resolves the most complex
legal and policy training issues. Recommends which ALJs be hired.
Investigates allegations of improper conduct and recommends
appropriate remedial actions.
Conditions of Employment
- Security and Background Requirements: If not previously
completed, a background security investigation will be required for
all appointees. 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. The U.S.
Department of Health and Human Services is an E-Verify Participant.
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. A financial disclosure statement is required. 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. 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.
MANDATORY QUALIFICATION: Candidates must have held a Federal ALJ
position, at the AL-3 level or above for at least one year.
Licensure Requirement: Former ALJs at the time of application, must
possess a professional license to practice law and be authorized to
practice law under the laws of a State, the District of Columbia,
the Commonwealth of Puerto Rico or any territorial court
established under the United States Constitution. Please read the
required documents section closely for information on what you need
to submit as proof that you are licensed and authorized to practice
law. Desirable Qualifications (DQs): As stated in the required
documents section below, candidates must submit a written narrative
that addresses each of the desirable qualifications listed below.
The written narrative must be formatted so that each desirable
qualification is individually addressed. Responses for each
desirable qualification should be no more than one page in length.
Experience in providing professional guidance, executive
leadership, and oversight of adjudicatory hearings. Experience in
overseeing and directing programs, issuing policies and procedures.
Broad legal knowledge and ability to develop quickly a specialized
knowledge of the Medicare program, law, adjudication procedures,
and related matters. Experience in analyzing and deciding extremely
difficult and complex technical, legal and organizational issues.
Ability to lead strategic change in a continuously changing
environment. Ability to lead an organization while fostering
inclusivity, creativity, cooperation and teamwork.
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
For more information on disability employment, please visit
Males born after December 31, 1959 must be registered or exempt
from Selective Service - http://www.sss.gov 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). If you
are unable to apply online, please go to
for more information on our alternate application method.
Keywords: Office of the Secretary of Health and Human Servic, Arlington , Deputy Chief Administrative Law Judge, Other , arlington, Virginia
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