Ombudsman Iii

Ombudsman III: This position works in a call center setting that will telework 100 % from anywhere in Texas, handling calls telephone phone calls from consumers, family members, and the public from 8am-5pm, Monday through Friday.- The position works under general supervision with moderate latitude for the use of initiative and independent judgment.**Essential Job Functions**:
Conducts intakes, tracks, investigates, and resolves inquiries and complaints related to Behavioral Health Services, (BH) including treatment of mental health conditions and substance use disorders. Receives and reports concerns and complaints relating to inappropriate care or mental health commitment. Make initial contacts by phone and/or in writing with consumers, their authorized representatives, Texas HHS staff overseeing State Hospitals and the Texas Medicaid program, and staff at Local Mental Health Authorities, Local Behavioral Health Authorities, advocacy groups, to investigate and resolve consumer complaints. Interacts professionally with BH Services consumers, their authorized representatives, and providers, to explain their rights relative to Behavioral Health Services. Coordinates with Texas HHS staff responsible for oversight of State Hospitals, Local Mental Health Authorities, Local Behavioral Health Authority, and the Texas Medicaid programs, to ensure appropriate response and resolution to BH consumer parity and other complaints. Making accurate referrals to external regulatory and oversight agencies to ensure appropriate referral and resolution of Behavioral Health Services consumer complaints. Develops appropriate points of contact for referrals of Behavioral Health Services consumer cases to other state and federal agencies. Conducts extensive research, investigates, in depth analysis, and resolves moderate to highly complex complaints regarding Behavioral Health Services. Making determinations regarding program and policy compliance. Escalating complex issues to management to appropriately find resolution. (40%)
- Organizes data to identify and determine trends in Behavioral Health Services consumer complaints and inquires. Organizes and maintains consumer data in a web-based case management system. (20%) Accurately and thoroughly document all issues, actions, analysis, findings, and resolutions in the Ombudsman database. Timely inputs accurate and complete case documentation by due date. (25%) Advocates for the rights of consumers seeking and receiving BH services. Recommends modifications to HHS policy related to Behavioral Health Services based on the finding of patterns and trends in consumer cases. Represents the HHS Office of the Ombudsman in public meetings and in agency workgroups with stakeholders, including presentation of case summaries. (10%) Assists with the development and distribution of outreach materials related to the Behavioral Health Services ombudsman that provide information to help consumers obtain Behavioral Health Services.
- Assist with development and delivery of training to Texas HHS staff performing consumer rights activities in State Hospitals, and Local Mental Health Authority staff performing consumer rights activities. Provides input into the development and integration of new policies and procedures related to Behavioral Health Services consumer cases. Identifies the need to update policies and procedures relating to Behavioral Health Services consumer cases. May distribute consumer-friendly documentation outlining consumer rights relative to Behavioral Health Services. (5%) Other duties as assigned.**Knowledge Skills Abilities**:
(a) Knowledge of federal and state laws and regulations related to Texas HHS programs, specifically Behavioral Health Services (mental health and substance use) and civil rights.
- (b) Knowledge of federal and state laws and regulations related to the availability and terms and conditions of Behavioral Health Services.
- (c) Knowledge of ombudsman principles and practices, including customer service practices and dispute resolution techniques.
- (d) Skill in mediation, conflict resolution, active listening, and interviewing.
- (e) Skill in establishing and maintaining effective working relationships, including the ability to work with people under pressure.
- (f) Skill in conducting research using internet and other sources, investigating complaints, recognizing problems and facilitating solutions.
- (g) Skill in querying eligibility databases.
- (h) Skill in communicating effectively, both verbally and in writing.
- (i) Skill in the use of computers and related equipment and software, including Windows, Word, Excel, Outlook, and database software.
- (j) Ability to work and communicate with individuals in personal crises and in confrontational situations as evidenced by the ability to maintain control of an interview.
- (m) Ability to determine complexity of issue and address issue with appropriate agency or program.
- (n) Ability to interpret, analyze, an