Administrative Hearing Specialist; AHS​/DLS; Internal

Administrative Hearing Specialist (AHS/DLS) - Internal

This opportunity is internal and available to current HCA employees only.

The Administrative Hearings Specialist represents the agency in hearings related to Washington Apple Health eligibility disputes. This role serves as the eligibility subject matter expert, hearing representative, and develops hearing packets that include a persuasive summary of the agency’s position and supporting exhibits. The position manages an active caseload from intake through resolution, coordinating with the Office of Administrative Hearings, the Health Benefit Exchange, and other State agencies to ensure timely and accurate adjudication.

All HCA employees will apply an equity lens to their work, which may include but is not limited to all analyses of core business and processes.

The Division of Legal Services (DLS) provides support to the entire agency to mitigate risks, comply with changing laws, and assist the agency in accomplishing its strategic and tactical goals. DLS’ mission is to “deliver legal and specialized professional support so HCA can provide high-quality health care through innovative health policies and purchasing strategies.” Its vision is to “be a model of excellent customer service and efficiency in the delivery of legal and specialized professional services.”

In addition to the agency-wide values, DLS values include excellence, dependability, customer focus, and integrity.

This position supports the HCA mission to provide access to medical care for all eligible Washington citizens. This position serves as an Administrative Hearings Specialist for the Washington Apple Health (WAH) Modified Adjusted Gross Income (MAGI) programs.

This position is eligible to telework but is occasionally required to report onsite to meet business needs. The default assigned work location of all Health Care Authority (HCA) positions – both on‑site and telework eligible positions – is within the State of Washington. This position reports to Olympia, WA. Frequency of onsite work will vary based on business and operational needs.

All agency employees are required to report on‑site in Olympia on their first and last days of employment to pick up and return state‑issued equipment, regardless of telework status or location.

• Represent the agency’s interests in Administrative Hearings (AH) regarding eligibility and other issues related to WAH. Represents the agency’s interests by providing argument as the eligibility subject matter expert during the hearing process, demonstrating how the rules support the agency’s decision.
• Pursue possible resolution prior to hearing. Research and analyze case history to include all client documents, income verification systems, and case notes to determine if the appropriate case actions were initially taken. Reprocesses cases if necessary to obtain correct eligibility results.
• Develop hearing packets for administrative proceedings to include an outline of the agency’s position in a report summarizing the facts and the agency’s position on the case. Provides exhibits to support the agency’s actions, and provides WACs, rules, and policy guidelines to further substantiate the eligibility determination.
• Files motions including motions to dismiss and motions for summary judgment when required. Determines and files the appropriate response to the appellant’s motions and exhibits.
• Coordinates with the Office of Administrative Hearings, the Washington Health Benefit Exchange (HBE) and representatives from other state agencies such as DSHS Community Services Office, Home and Community Services, and Office of Administrative Hearings to ensure a seamless appeals process.
• Manages a hearings caseload. Uses Barcode to triage and assign hearing requests and documents. Monitors the hearing process through JAHCS to ensure all actions are taken timely and deadlines are met. Maintains the AH docket calendar. Works with supervisor and other AHSs to ensure full coverage of the hearing schedule.
• Tracks case details and resolutions in JAHCS to capture accurate case data.
• Utilize multiple…