Ombudsman

MTM•Warwick, RI

About The Position

What will your job look like? The Ombudsman is MTM’s designated member advocate responsible for investigating issues and working towards resolution for all members in the assigned region in accordance with client requirements and MTM policies and procedures. The Ombudsman partners with advocacy groups, other local and State Ombudsman, and providers while acting as a resource to assist members whose issues may exceed MTM contract requirements. This role must reside in the State of Rhode Island.

Requirements

High school diploma or GED
2+ years’ experience in a role within Quality Management, Health Care, Social Work or member advocacy
2 + years’ experience in Customer Service
Experience delivering presentations both in person and virtually
Excellent communication skills, with an emphasis on grammar and spelling
A working knowledge of contracts
Ability to tactfully question and obtain information
Excellent organizational and interpersonal skills
Demonstrated ability to manage multiple priorities
Ability to handle confidential information in a professional manner
Ability to accomplish duties/tasks with little direct supervision
Ability to prioritize tasks and deadlines
Excellent presentation skills
Ability to problem solve and troubleshoot
Ability to communicate with all levels of employees as well as external customers
Ability to build relationships
Ability to use basic office equipment
Proficient in Microsoft Office Suite

Nice To Haves

Some college preferred
Ombudsman experience or certification, strongly preferred (CO-OP)

Responsibilities

Identify and report systematic issues that leads to complaints and work to develop a solution
Know and drive processes, based on the contract requirements, partnering with market leadership
Attend meetings with advocacy groups on behalf of MTM
Identify special advocacy groups and tribal organizations and provide company related educate on the benefits of a partnership
Handle specialized trips and member interactions and escalation
Determine which groups will be best utilized within the organization based on assigned market needs
Determine outreach plan that their assigned market needs
Host and manage Member Advisory Committee (MAC) meetings
Participate in Transportation Advisory Committees (TACs) meetings
Create market specific resources and presentations, based on the needs of the market
Participate in ride along with the member to determine appropriate service was provided
Investigate and document all reported issues, providing thorough and timely follow up
Analyze data, and present information to improve member experience
Develop and Implement processes to improve member experience in coordination with on site and corporate stakeholders
Document escalations and action plans in the appropriate intake systems
Maintain an impacted member list and provide follow ups to ensure the members got to and from their appointments safely and on time
Educate and provide members information on their rights
Triage complaints submitted via fax, voice mail or email
Provide follow up contact to recipients per their request in regards to complaint resolution
Use complaint data to recommend education and process improvement
Proofread any data submitted to the state for escalated issues
Monitor and report on members access to MTM as it relates to those with disabilities, language barriers and technology