Job Type

Full Time Contract


Details: $45K



Start Date:


Application Deadline:



11 Dartmouth Street
Suite 301
United States


The Ombudsman serves as a complaint response and investigatory interface for people contacting the Ombudsman Office by phone, email or in person. This position provides ombudsman services, facilitates communications, investigates and seek remedies for,· and provides information and assistance as necessary regarding concerns and issues raised by MassHealth Health Plan enrollees and other interested individuals. The Ombudsman 1-Lead then categorizes and documents these issues and concerns in a secured database system and submits required reports as necessary. The Ombudsman operates in a manner to preserve the privacy and confidentiality of those seeking services and maintains an independent, neutral/impartial position with respect to the concerns raised.

The Ombudsman is part of a team that will be trained in the Independent Living Philosophy; Eligibility and enrollment process for all MassHealth Health Plans; Each Health Plan's services and benefits, rights and responsibilities, each Health Plan's resolution and appeals processes; and other informational resources. The Ombudsman will also have access to the “Health Plan" database to facilitate accurate and timely delivery of program specific information.

The Ombudsman is also responsible for supporting and assisting other ombudsmen should the OOM or Project Director be unavailable. The Ombudsman operates under the general direction of the Ombudsman Operations Manager and in accordance with contractual requirements.

Job Duties:

1.  General Duties

a. Provides information and referral to contacts regarding MassHealth, MassHealth Health Plan programs, program services and related concerns or issues

b. Researches (as necessary) and provides information to inquiry requests

c. Listens and understands issues while remaining neutral with respect to the facts attempting to understand the issue from the perspective of the individual

d. Assists in reframing issues and helps complainants focus attention on and evaluate potential options. Helps individuals to understand the interests of various parties related to their issue(s)

e. Guides or coaches individuals as required to work directly with MassHealth health Plans, and other parties, including the use of, and/or referral to, informal and formal resolution

f.  Facilitates mediations and resolution processes, including resolving issues between parties through various types of informal mediation

g. Enters data into, and accesses information from, the Case Management and Health Plan databases in accordance with the security and confidentiality policies and requirements established by and contractual obligations

h. Supports MassHealth Health Plan enrollees throughout grievance and appeals processes

i.  Obtains consent from a complainant before:

     i. Proceeding with the investigation

     ii. Releasing the identity of the complainant

j. Informs potential and current MassHealth Health Plan enrollees as to how to obtain services from MassHealth Health Plan contractors and from the Ombudsman Office

k. Serves as an informal liaison between the Office and Interested Parties, enrollees, MassHealth Health Plans and stakeholders

l.  Requests information and assistance from MassHealth Health Plan contractors and MassHealth as necessary in order to carry out the discharge of its responsibilities

m. Keeps the Ombudsman Operations Manager informed regarding the overall status clientele and activities

n. Identifies new issues and opportunities to respond to systemic change in the State's MassHealth Health Plan programs. Provides unfiltered information in order to produce insight to issues and resolutions. Serves as a source for detection and early warning of new issues. Suggests systemic changes to improve MassHealth Health Plan services, benefits and processes

o. Provide the Outreach Manager with stories of MassHealth Health Plan programs and clientele that can be helpful to MassHealth Health Plans and marketing and outreach campaigns

p. Complies with Ombudsman Position Contractual Requirements Appendix A

q. Other duties as assigned

2. Protected Information Security

a. Ensures paper copies of personally identifying information (PII) or other sensitive information are only kept in locked filing cabinets and/or offices identified by DPC and third-parties are not allowed access to physical or electronic data or records

b. Ensures and maintains the privacy and confidentiality of information and records. Is responsible for maintaining the privacy, integrity and storage of personal identifying information, including the accurate and timely reporting of any actual or potential security or PII breaches as contractually required

c. At the direction of the Project Director or OOM and accordance with State and policies and procedures provides EOHHS with access to program data

d. Complies with all applicable laws, regulations and contractual provisions and abides by the procedures and requirements to maintain privacy and confidentiality as outlined in the EOHHS contract Appendix B

3. General Program Support

a. Perform day-to-day program tasks such as documenting contacts, preparing meeting notes and reports and internal support materials; following operational, programmatic, operations, reporting and financial policies and procedures; faxing; copying; following established protocols for paper and electronic files and filing system; processing forms and paperwork; assists with compiling, completing and distribution of reporting documents

b. Conducts themselves in a professional manner at all times. Answers and fields telephone calls. Responds to and fields emails. Provides information within protocol parameters to the general public, clientele, grant representatives and subcontractors, and others as directed by answering questions and responding to informational requests in an appropriate, accurate and timely manner

c. Documents required grant activities and prepares and submits all required reporting paperwork in a timely manner

d. Ensures the professional quality, technical accuracy, and timely completion and delivery of duties and responsibilities of their position


Demonstrated Competencies in the following:

A. Strong interpersonal communication skills, including an ability to listen objectively but with empathy to people of varying levels of education and abilities

B. Experience using computers and ability to navigate the internet

C. Excellent problem solving and conflict resolution skills

D. Ability to work effectively in a team environment

E. Ability to multitask and work independently

F.  Demonstrated excellent written and oral communication skills; demonstrated organizational skills

G. Demonstrated ability to remain calm in a crisis, nonjudgmental and maintain confidentiality

H. Demonstrated ability to convey complex information in a simple, clear, and understandable manner

I.  Demonstrated excellent written and oral communication skills

J. Demonstrated organizational skills




A Bachelor's degree or equivalent in social science, conflict resolution or related field including human resources, social services, psychology or counseling. Relevant professional experience or academic work: may be substituted for a Bachelor's degree.          



  • At least one year customer service
  • At least three years of experience working in a customer service, health care setting or related field with supervisory experience is preferred.
  • Prior knowledge of ombudsman programs, disability civil rights policy, and the health care environment in Massachusetts is a plus, but not required
  • Experience with customer or client services preferred
  • Prior experience with state or federal health care programs for people with disabilities preferred
  • Ability to work effectively with diverse populations, with a strong preference for someone with a lived experience or extensive cultural knowledge of disabilities
  • Preferred experience working with MassHealth programs and services
  • Ability to properly maintain proprietary and confidential information

Upon hire, the successful candidate must be cleared through the state's Criminal Offender Record Information (CORI) service.

Candidates should submit a cover letter and resume to:

Attn: Amy Kalogeropoulos

Disability Policy Consortium

11 Dartmouth Street, Ste. 301

Malden, MA 02148

Or an email with a cover letter and resume as PDF attachments to with subject: Ombudsman Position


Worker’s Comp, Health Insurance Premium Coverage: 50% Family and 75% Individual, and Business Travel Mileage Reimbursement. 

Professional Level


Minimum Education Required

4-year degree

How To Apply