About the Role
This role involves managing medical hearings processes, ensuring compliance with state and federal regulations, preparing case materials, and supporting fair and timely decisions for individuals appealing health services determinations.
Responsibilities
- Review and evaluate medical appeals for accuracy and compliance
- Prepare documentation for administrative hearings
- Ensure adherence to state and federal regulatory standards
- Communicate with stakeholders including applicants, providers, and agency staff
- Support fair and impartial hearings processes
- Maintain case files and ensure data integrity
- Interpret policies related to medical eligibility and benefits
- Respond to inquiries regarding hearing procedures
- Coordinate with legal and program staff as needed
- Track case progress and meet established timelines
- Identify systemic issues in medical compliance processes
- Recommend process improvements for efficiency
- Participate in training and professional development
- Ensure confidentiality of sensitive health information
- Assist in resolving complex eligibility disputes
- Conduct follow-up on pending hearing cases
- Prepare summaries for hearing officers
- Support consistency in decision-making across cases
- Stay current with changes in health policy and regulations
- Serve as a resource for procedural questions
- Facilitate communication between departments
- Document actions taken during case reviews
- Ensure equitable treatment of all parties
- Uphold due process standards in all proceedings
- Assist with quality assurance reviews
Compensation
Salary commensurate with experience and qualifications
Work Arrangement
Hybrid work environment with both remote and on-site components
Team
Collaborative team within a state government agency focused on regulatory compliance and fair hearings processes
Underfill Opportunity
This position is posted as a Compliance Specialist 3 but may be filled at the Compliance Specialist 2 level based on candidate qualifications and budget considerations.
Work Location
This role is based in Salem, Oregon, with hybrid work options allowing for both remote and in-office work as determined by operational needs.
Application Process
Applicants must submit a resume and completed state application form to be considered. Incomplete applications will not be reviewed.
Veterans' Preference
Eligible veterans may claim preference points in the application process by submitting required documentation.
Background Check
Position requires a criminal background check due to access to sensitive personal and health information.
Equal Employment Opportunity
The agency is an equal opportunity employer and values diversity, equity, and inclusion in its workforce.
Accommodations
Reasonable accommodations are available for applicants with disabilities during the hiring process upon request.
Bargaining Unit
This position is part of a collective bargaining unit represented by SEIU Local 503.
Probationary Period
New hires are subject to a six-month probationary period during which performance is closely evaluated.
Union Dues
Employees in this classification may be required to pay union dues as part of collective bargaining agreement terms.
Not available
