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.

Under the direction of the Managing Ombudsman for Behavioral Health Ombudsman (BHO) the Ombudsman III will assist in resolving various types of grievances, disputes or complaints related to Local Mental Health Authorities, Local Behavioral Health Authorities, State Hospitals, and HHS programs. Work involves assisting the general public with information and resolution of moderate to complex issues via the Office of the Ombudsman toll-free lines, e-mail, online submissions, faxes, and letters.

Advises on and explains relevant state and federal rules, regulations, programs, and procedures. Processing and resolves issues and complaints by initiating investigations, researching HHS policies, procedures, rules, and regulations. The Ombudsman III may assist in planning, developing, and implementing a comprehensive complaint management system for consumers seeking to navigate and resolve complaints related to access Behavioral Health (BH) Services (treatment of mental health conditions and substance use disorders). The position performs moderate to highly complex complaint resolution work, provides extensive coordination and problem solving related to HHS services, maintains a workload, completes high level research and resolution for highly sensitive and confidential complaints, and evaluates adherence to policies, procedures, and guidelines to ensure compliance with program requirements and fair treatment of consumers seeking BH Services.

The Ombudsman III assists consumers navigate the Texas HHS system and assists consumers seeking BH Services outside the Texas HHS system and those that are not insured. The position interacts directly with consumers seeking BH Services, other state agency staff and leadership, federal agencies, advocacy groups, and other HHS staff. The Ombudsman III identifies trends in Behavioral Health Services consumer complaint reporting and is responsible for producing summaries of case resolutions appropriate for distribution to Texas HHS staff, external regulatory and oversight agencies, and legislatively required stakeholders.

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, and evaluate complex program policy and rules and regulations and make accurate assessments.

(o) Ability to elicit factual information or perform required duties in order to proceed with an investigation.

(p) Ability to interact with all clients, internal and external, using empathy and compassion.

(q) Ability to coordinate with other staff, departments, officials, agencies, organizations, and the public.

(r) Ability to organize and prioritize workload and perform work on own initiative.

(s) Ability to meet tight deadlines.

(t) Ability to use an automated tracking system.

Registration or Licensure Requirements:

none Initial Selection Criteria:

Minimum of bachelor's degree from an accredited university or college in the field of social work, sociology, psychology, mental health counseling, or human services, is preferred.

Minimum two years of current professional experience working with individuals receiving behavioral health services, or substance use disorder, or their family members, through HHS programs, local mental health authority, local behavioral health authority, or state psychiatric hospitals.

Experience in handling complaints and familiar with the complaint investigation process.

Additional Information:

Requisition Number 569347

This position will telework 100% from anywhere in Texas consistent with HHS telework policies. Employees are responsible for providing the necessary infrastructure for teleworking, including office furnishings (desk, chair, lamps, etc.), and utilities (reliable internet, electricity, telephone). The agency will not reimburse for utilities, or any items purchased for telework use, including office supplies, internet service, or maintenance or repair of personally owned equipment.

Travel to a regional HHS office for pick up or repair HHS-issued equipment may be required. The offered salary will be determined in accordance with budgetary limits and the requirements of the HHS Human Resources Manual. MOS Code:

There may be no military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position. All active duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information see the Texas State Auditor's Military Crosswalk at http://www.hr.sao.state.tx.us/Compensation/JobDescriptions.aspx.

HHS agencies use E-Verify. You must bring your I-9 documentation with you on your first day of work.

I-9 Form - Click here to download the I-9 form.

In compliance with the Americans with Disabilities Act (ADA), HHS agencies will provide reasonable accommodation during the hiring and selection process for qualified individuals with a disability. If you need assistance completing the on-line application, contact the HHS Employee Service Center at 1-888-894-4747. If you are contacted for an interview and need accommodation to participate in the interview process, please notify the person scheduling the interview.

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