Ombudsman Specialist

At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

Come join us and be part of a purpose driven company who is invested in your future!

Job Summary

This position is responsible for investigating and addressing member issues and attempting to resolve them within the organization; identifies systemic issues including, but not limited to issues stemming from access to services, prompt attention from care coordinators; provides assistance to members regarding their rights and responsibilities as outlined by Federal, state and local regulatory and contractual obligations applicable to government programs. This position is also responsible for helping parties reach mutually beneficial solutions.

Please note: This is a hybrid role and will work in the office three days a week.

Required Job Qualifications:

• Bachelor Degree OR 4 years work experience in a healthcare environment or for community service agency

• 2 years' experience coordinating efforts across departments/divisions or a community service organization

• Lead, supervisory or management experience as demonstrated through work or community involvement

• Ability and willingness to travel weekly, as needed, including regular overnight stays

• Ability and willingness to work very flexible schedule, including weekends and evenings

• Experience working independently and problem solving on the spot

• Verbal and written communication skills including interpersonal skills and assisting public

• Organizational skills and experience with managing multiple tasks

• Experience creating reports as required

• PC proficiency to include Word, Excel, PowerPoint, Access Database and Lotus Notes

Preferred Job Qualifications:

• Working knowledge of Centennial Care requirements

• Working knowledge of MCO internal processes including but not limited to care coordination and utilization management activities, appeals and grievances. Etc

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.