Ombudsman Operations Manager


Job Type

Full Time Contract

Remote

Ok

Salary

Minimum: $60,000.00
Maximum: $60,000.00

Published:

03/29/2018

Start Date:

05/15/2018

Application Deadline:

04/27/2018

Address

11 Dartmouth Street
Suite 301
Malden
MA
02148
United States

Description

The Ombudsman Operations Manager oversees the daily operations and provides ombudsman services as required. Ombudsman responsibilities include facilitating communications, investigating and seeking remedies for, and providing information and assistance as necessary regarding concerns and issues raised by enrollees (or their legal representatives) and other interested individuals. This also includes categorizing and documenting these issues and concerns in a secured database system and submitting required reports as necessary.


The Ombudsman Operations Manager (OOM) 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 OOM supervises the work and activities of the Ombudsmen, Community Liaisons and ASL Interpreter. The OOM operates under the general direction of the Project Director and in accordance with contractual requirements.       


Job Duties:


1. General Duties

a. Oversees day-to-day operations including, but not limited to:

i. Ombudsman services

  ii. Supervising the work and activities of ombudsmen personnel

   iii. Outreach and marketing activities

   iv. Reporting and documentation requirements

b. Keeps the Project Director informed regarding the overall status operations and activities and clientele


2.  Ombudsman Duties

a. Provides information and referral to clientele regarding MassHealth Health Plan programs and Ombudsman 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 clientele focus attention on and evaluate potential options. Helps individuals to understand the interests of various parties related to their issue(s)

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

f. When asked, supports individuals with other parties, including the use of, and/or referral to, informal resolution resources

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

h. When asked, supports clientele throughout the various MassHealth Health Plan program's grievance and appeals processes

i. Obtains consent from the complainant before:

i. Proceeding with the investigation

   ii. Releasing the identity of the complainant

j. Informs potential and current Ombudsman clientele as to how to obtain services from MassHealth, MassHealth Health Plan programs, and from the Ombudsman Office

k. Serves as a formal liaison between the Ombudsman program and Interested Parties, enrollees, MassHealth Health Plans, providers and stakeholders

l. Requests information and assistance from MassHealth Health Plans and MassHealth as necessary in the discharge of its responsibilities

m. 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

n. Identifies new issues and opportunities for systemic change in the State's MassHealth Health Plan program. Provides unfiltered information in order to produce insight to issues and resolutions. Serves as one source for detection and early warning of new issues. Suggests systemic changes to improve MassHealth Health Plan program services and service delivery

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

p. Complies with MassHealth Health Plan Ombudsman Contractual Requirements

q. Maintains the work-related schedules of the Community Liaisons, Ombudsman personnel, and ASL Interpreter and grant related events, meetings, interviews, and other similar activities.

r. Conducts biannual personnel evaluations of Community Liaisons, Ombudsman personnel, and ASL Interpreter

s. Other duties as assigned


3.  Protected Information Security

a. Ensures that paper copies of personally identifying information (PU) 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 that electronic versions of personal information are only stored on servers that are reasonably password protected

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

d. At the direction of the Project Director and accordance with State and policies and procedures provides the Executive Office of Health and Human Services (EOHHS) with access to program data

e. 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


4.  General Program Support

a. Assist in the development of internal documentation and reporting forms; and informational, training and marketing materials

b. For all electronic database systems: 1) Ensures the timely and accurate input of data by personnel, and 2) Ensures each database accurately reflects the contractual, operational and reporting data metric requirements related to, and necessary for, recording and documenting the provision of ombudsman services and financial activities

c. Make recommendations to the Project Director as necessary to update and ensure the security of, and access to, electronic information and messaging systems including but not limited to Case Management and Health Plan databases, website, and public communications

d. Documents required grant activities and prepares and submits all required reporting paperwork

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


Qualifications:


Demonstrated Competencies in the following:


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

B. Experience using computers and ability to navigate the internet

C. Excellent problem solving, conflict resolution, mediation and negotiation skills

D. Proactive referral of issues and concerns to management

E. Supervisory experience

F.  Mediation and negotiation skills

G. Ability to work effectively in a team environment

H. Ability to multitask and work independently

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

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

K. Demonstrated excellent written and oral communication skills

L. Demonstrated organizational skills

M. 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


PROFESSIONAL REQUIREMENTS:


Education:

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.          


Experience:

  • ·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 akalogeropoulos@dpcma.org with subject: Ombudsman Operations Manager 

Benefits

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

Professional Level

Professional

Minimum Education Required

4-year degree

How To Apply


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