Hearing Officer

The Board of Hearings is the hearing unit within the Executive Office of Health and Human Services, Office of Medicaid responsible for the adjudication of MassHealth applicant, member and/or appeal representative appeals for approximately 1.8 million MassHealth applicant/members and for adjudication of provider Claims for Adjudicatory Hearings.

The Board of Hearings Unit is seeking qualified legal professionals for the position of Hearing Officer. The incumbent will preside, as an impartial Hearing Officer of the Board of Hearings, over Fair Hearings held pursuant to 130 CMR 610.000 et seq., G.L. c. 30A, c. 118E and the rules and regulations thereunder and Claims for Adjudicatory Hearing held pursuant to 130 CMR 450.241 and 450.243, and the Standard Adjudicatory Rules of Practice and Procedure, found at 801 CMR 1.00 et seq. Perform legal research, analysis and writing for Board of Hearings decisions, guidelines for practice and reference tools. Assist as assigned in the education and training of Board of Hearings staff.

The purpose of this position is to preside, as the impartial fact finder, over an administrative hearing, a legal proceeding, where dissatisfied applicants, members, nursing facility residents and providers can obtain an administrative determination of the appropriateness of certain action(s) or inaction(s) by the MassHealth Agency/Agency Contractors/Agents.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

• Identify jurisdictional issues, issues of representation and issue for fair hearing. Rule on jurisdictional issues, issues of representation and issues for hearing. Instruct the parties in the procedural format of a fair hearing.
• Administer the oath or affirmation to anyone who will testify.
• Inform appellants who are not fluent in English of the right to interpretation by their own interpreter or an interpreter provided by the Board of Hearings. Administer the interpreter oath or affirmation.
• Assist the parties in making a full and free statement of the facts. Ensure an orderly presentation of the evidence. Ensure that all parties have a full opportunity to present their claims and secure witnesses and evidence when necessary. Order, rule on and preside over prehearing conferences to assist the parties in identification of witnesses, evidence and oral/written arguments in support of their respective positions and to encourage settlement. Formally conference at prehearing conference and/or hearing with the parties to clarify issues, witnesses and evidence to ensure a effective and efficient presentation of facts at hearing.
• Introduce into the record any regulations, statutes, memoranda, or other materials he/she believes relevant to the issue at the hearing as presented by the appellant and/or MassHealth.
• Receive, rule on, exclude or limit evidence. Conduct legal research of presented evidence to meet the obligation of finding facts and rendering analysis and conclusions of law.
• Ensure a record is made of the proceeding(s), including but not limited to, the documentary record appropriately marked with completed exhibit sheet and tape/digital recording appropriately labeled, dated and time series completed.
• Rule on requests for continuances, reopen, reconvene and/or motions pursuant to 130 CMR 610.000 et seq., G.L. c. 30A, c. 118E and 801 CMR 1.00 et seq.
• Render a fair, independent and impartial decision based on the issues and evidence presented at the hearing. Decision shall be formatted to preserve the confidentiality of the proceeding.
• Designate appropriate issue code on decisions for public view placement on decision drive.
• Preside over issues remanded pursuant to 130 CMR 610.091 and/or court ordered remands pursuant to G.L. c. 30A.
• In the event of a request for mediation of a dispute preside as mediator pursuant to 130 CMR 610.051.
• Advise hearings staff through monthly “Hearing Officer” presentation of hearing matters by presenting topics, legal research, regulations and hearing outcomes. Review court decisions and opinions related to G.L. c. 30A and reviewing courts. Keep current, updated regulation volumes for individual use and as assigned at each hearing site. Demonstrate proficiency in accessing designated library and decision drive on Division’s network. Establish, as assigned, the Board of Hearings reference library.
• Provide information to the Agency and the public by answering general inquiries related to the function of the Board of Hearings and the Board of Hearings rules and regulations. With respect to inquiries made to the Board of Hearings confirm the impartial responsibility of the hearing officer and ensure that no ex-parte communications regarding matters for hearing are discussed. Perform related duties such as generating reports, assist in the scheduling of hearings and conferences and review circulated periodicals and reference materials. Participate in formal education and training regarding the function of the Board of Hearings and role of the hearing officer.

Required Qualifications:

· Knowledge of the theory, principles and practices of the law including administrative and constitution law.

· Knowledge of the procedures following in administrative proceedings.

· Knowledge of the methods of technical and general report writing for the Board of Hearings reports.

· Ability to read and interpret legal documents such as memoranda, decisions, briefs, opinions and contracts.

· Ability to understand and apply the laws, rules and regulations governing operations and assigned unit activities through the fair hearing proceeding.

· Ability to exercise sound judgement and render impartial decisions.

· Ability to make decisions and act quickly and appropriately in stressful situations and to maintain a calm demeanor.

· Ability to analyze and determine the applicability of legal data to find facts, draw conclusions and render appropriate decisions.

· Ability to explain the procedures, guidelines and policies governing the Board of Hearings operations and activities.

· Ability to write concisely, express thoughts clearly and develop ideas in a logical sequence.

Preferred Qualifications:

• Knowledge of the terminology, symbols and standard abbreviations used in legal and administrative practice.
• Ability to understand, explain and apply the laws and rules governing the presentation and admissibility of evidence.
• Knowledge of legal research methods and procedures.
• Ability to exercise sound judgment and render impartial decisions.
• Ability to exercise discretion in handling confidential information and maintain such confidentiality in the hearing proceedings through to decision publication.
• Ability to work independently.
• Ability to assemble items of information in accordance with established procedures.
• Ability to exercise sound judgment.
• Ability to establish and maintain harmonious working relationships with others.
• Ability to supervise, including planning and assigning work according to the nature of the job to be accomplished and to determine new hearing staff education and training needs to assist in a training schedule.
• Knowledge of principles and practices of supervision techniques.

About MassHealth:

MassHealth is the Commonwealth's Medicaid and Children's Health Insurance Program, providing comprehensive healthcare coverage and services to approximately two million Massachusetts residents. Through partnerships with providers, health plans, community organizations, and government agencies, MassHealth works to improve health outcomes, reduce disparities, strengthen care coordination, and ensure access to high-quality, person-centered care. As one of the largest Medicaid programs in the country, MassHealth plays a critical role in advancing healthcare innovation, promoting health equity, and supporting the well-being of individuals, families, and communities across the Commonwealth.

Learn more: MassHealth