What are the responsibilities and job description for the Ombudsman I - 100% Remote from anywhere in Texas position at Texas Health and Human Services?
Date: Jan 7, 2025
Location:
AUSTIN, TX
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Functional Title: Ombudsman I - 100% Remote from anywhere in Texas
Job Title: Ombudsman I
Agency: Health & Human Services Comm
Department: Ombudsman Complaint Services
Posting Number: 2059
Closing Date: 01/21/2025
Posting Audience: Internal and External
Occupational Category: Community and Social Services
Salary Group: TEXAS-B-17
Salary Range: $3,581.33 - $4,197.95
Shift: Day
Additional Shift: Days (First)
Telework: Full-Time
Travel: Up to 5%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Facility Location:
Job Location City: AUSTIN
Job Location Address: 4601 W GUADALUPE ST
Other Locations: Austin
MOS Codes
4402,4421,4430,250X,27A,51JX,92J0,LGL10
Job Description
Ombudsman I
This call center position will telework 100% from anywhere in Texas. Under the direction of the Managing Ombudsman of the Ombudsman Complaint Services Team, the Ombudsman I will assist in resolving or mediating various types of grievances, disputes or complaints related to 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. Triages and resolves issues and complaints by initiating investigations, researching HHS eligibility and enrollment systems and policy to determine program compliance, explaining policy and rules, and making referrals and/or escalations as needed. Provides education to HHS clients regarding the appeal and Fair Hearing process. Receives and reviews issues and complaints from clients, providers, government agencies, advocacy groups, and other stakeholders. Identifies issue and problem trends and alerts management and provides recommendations for resolution. Assists with the coordination of workflow to ensure effective delivery of services. Documents all issues and actions in a database. Tracks case information and case actions in a database. Responds verbally and in writing to clients. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment.
Essential Job Functions
EJF 1. On a daily basis, follow unit procedures to provide courteous and professional service on all contacts received by the general public, providers, advocacy groups, HHS program areas, and other stakeholders. Resolve moderate to complex issues and complaints by:
EJF 2. On a daily basis, conduct intake of issues and complaints received by HHS clients, providers, advocacy groups, other HHS program areas, and other stakeholders. Take calls on a statewide toll-free helpline, and respond to emails, online submissions, faxes and letters. Prepares and sends acknowledgments via email while complaints are being processed. Maintain production by handling share of incoming contacts within established guidelines and requirements and adhering to scheduled work activities. (40%)
EJF 3. On a daily basis, accurately and thoroughly document all issues, actions, analysis, findings, and resolutions in the Ombudsman database. (20%)
EJ4. Report to Ombudsman management recurring issues and problem trends that may affect the administration of HHS programs management, with recommendations for improvement to include HHS policy/procedure changes, changes to TAC, or vendor contract changes. (5%)
EJ5. Other duties assigned
Knowledge Skills Abilities
None
Initial Selection Criteria
A minimum of 2 years of current experience determining eligibility for Texas Works programs (TANF, Medicaid and SNAP Food Benefits, etc). Experience handling complaints is preferred. Experience working in a call center environment is preferred.
Additional Information
Employees will telework 100% from anywhere in Texas, consistent with HHS telework policies. Employees are responsible for providing the necessary infrastructure for working at home, 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 use at home, including office supplies, internet service, or maintenance or repair of personally owned equipment. Travel to a regional HHS office for pick up or repair of HHS-issued equipment may be required.
MOS Code
No equivalent MOS code.
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.
Top 10 Tips for Success when Applying to Jobs at HHSC and DSHS
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Active Duty, Military, Reservists, Guardsmen, And Veterans
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
ADA Accommodations
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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.
Pre-Employment Checks And Work Eligibility
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
Nearest Major Market: Austin
Location:
AUSTIN, TX
Join the Texas Health and Human Services Commission (HHSC) and be part of a team committed to creating a positive impact in the lives of fellow Texans. At HHSC, your contributions matter, and we support you at each stage of your life and work journey. Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more. Explore more details on the Benefits of Working at HHS webpage.
Functional Title: Ombudsman I - 100% Remote from anywhere in Texas
Job Title: Ombudsman I
Agency: Health & Human Services Comm
Department: Ombudsman Complaint Services
Posting Number: 2059
Closing Date: 01/21/2025
Posting Audience: Internal and External
Occupational Category: Community and Social Services
Salary Group: TEXAS-B-17
Salary Range: $3,581.33 - $4,197.95
Shift: Day
Additional Shift: Days (First)
Telework: Full-Time
Travel: Up to 5%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Facility Location:
Job Location City: AUSTIN
Job Location Address: 4601 W GUADALUPE ST
Other Locations: Austin
MOS Codes
4402,4421,4430,250X,27A,51JX,92J0,LGL10
Job Description
Ombudsman I
This call center position will telework 100% from anywhere in Texas. Under the direction of the Managing Ombudsman of the Ombudsman Complaint Services Team, the Ombudsman I will assist in resolving or mediating various types of grievances, disputes or complaints related to 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. Triages and resolves issues and complaints by initiating investigations, researching HHS eligibility and enrollment systems and policy to determine program compliance, explaining policy and rules, and making referrals and/or escalations as needed. Provides education to HHS clients regarding the appeal and Fair Hearing process. Receives and reviews issues and complaints from clients, providers, government agencies, advocacy groups, and other stakeholders. Identifies issue and problem trends and alerts management and provides recommendations for resolution. Assists with the coordination of workflow to ensure effective delivery of services. Documents all issues and actions in a database. Tracks case information and case actions in a database. Responds verbally and in writing to clients. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment.
Essential Job Functions
EJF 1. On a daily basis, follow unit procedures to provide courteous and professional service on all contacts received by the general public, providers, advocacy groups, HHS program areas, and other stakeholders. Resolve moderate to complex issues and complaints by:
- Performing in-depth analysis of moderate to complex issues and complaints which includes: researching and interpreting state and federal rules and regulations, agency procedures, and client rights and responsibilities, including Texas Works and Medicaid for the Elderly and People with Disabilities handbooks, as well as other HHS programs; interpreting client specific information in HHS and vendor eligibility and enrollment systems, and researching the internet; and determining whether a complaint may be handled within the initial contact or requires escalation for the purpose of investigation.
- If upon research, additional issues/errors are identified, escalating issue/error to Ombudsman III staff or HHS program areas to be addressed and make recommendation of actions to achieve final resolution. Requests responses regarding complaints from HHS program staff, including prompting for responses to determine final resolution of complaints.
- Making initial contacts by phone or in writing to HHS clients, providers, HHS program areas, Managed Care Organizations, advocacy organizations, HHS vendors, and/or local resources to mediate resolutions of issues and complaints.
- Making determinations regarding program and policy compliance.
- Escalating complex issues that cannot be resolved within initial contact to Ombudsman II and III staff with recommendations for actions to achieve final resolution.
- Providing accurate and appropriate information and referrals to HHS clients regarding other HHS program areas and vendors, other state agencies, and local resources.
- Educating and advising the general public and stakeholders on HHS programs and services, procedures, state and federal rules and regulations, the Fair Hearing and appeal process, and empowering HHS clients to navigate the HHS system and advocate for themselves when possible
EJF 2. On a daily basis, conduct intake of issues and complaints received by HHS clients, providers, advocacy groups, other HHS program areas, and other stakeholders. Take calls on a statewide toll-free helpline, and respond to emails, online submissions, faxes and letters. Prepares and sends acknowledgments via email while complaints are being processed. Maintain production by handling share of incoming contacts within established guidelines and requirements and adhering to scheduled work activities. (40%)
EJF 3. On a daily basis, accurately and thoroughly document all issues, actions, analysis, findings, and resolutions in the Ombudsman database. (20%)
EJ4. Report to Ombudsman management recurring issues and problem trends that may affect the administration of HHS programs management, with recommendations for improvement to include HHS policy/procedure changes, changes to TAC, or vendor contract changes. (5%)
EJ5. Other duties assigned
Knowledge Skills Abilities
- Knowledge of health and human services programs, services and procedures.
- Knowledge of applicable rules, regulations, policies, and functions of the Commission
- Skill in working on an Automated Call Distribution (ACD) hotline.
- Skill in communicating effectively both verbally and in writing.
- Skill in establishing and maintaining effective working relationships, including the ability to work with people under pressure, and resolve conflicts.
- Skill in using eligibility and claims databases.
- Skill in conducting research and complaint resolution.
- Skill in analyzing and preparing documents, reports and correspondence.
- Skill in researching complaints and recognizing and resolving problems.
- Ability to determine the complexity of the issue and triage to the appropriate agency or program.
- Ability to conduct research using the Internet and other sources.
- Ability to interpret, and apply agency, state, and federal rules, regulations, policies and procedures.
- Ability to use an automated tracking system.
- Ability to work and communicate with individuals in personal crises and in confrontative situations as evidenced by the ability to maintain control of an interview.
- Ability to elicit factual information or perform required duties in order to prepare for an investigation.
- Ability to interact with all clients, internal and external, using empathy and compassion.
None
Initial Selection Criteria
A minimum of 2 years of current experience determining eligibility for Texas Works programs (TANF, Medicaid and SNAP Food Benefits, etc). Experience handling complaints is preferred. Experience working in a call center environment is preferred.
Additional Information
Employees will telework 100% from anywhere in Texas, consistent with HHS telework policies. Employees are responsible for providing the necessary infrastructure for working at home, 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 use at home, including office supplies, internet service, or maintenance or repair of personally owned equipment. Travel to a regional HHS office for pick up or repair of HHS-issued equipment may be required.
MOS Code
No equivalent MOS code.
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.
Top 10 Tips for Success when Applying to Jobs at HHSC and DSHS
Review our Tips for Success when applying for jobs at DFPS, DSHS and HHSC.
Active Duty, Military, Reservists, Guardsmen, And Veterans
Military occupation(s) that relate to the initial selection criteria and registration or licensure requirements for this position may include, but not limited to those listed in this posting. All active-duty military, reservists, guardsmen, and veterans are encouraged to apply if qualified to fill this position. For more information please see the Texas State Auditor’s Job Descriptions, Military Crosswalk and Military Crosswalk Guide at Texas State Auditor's Office - Job Descriptions.
ADA Accommodations
In compliance with the Americans with Disabilities Act (ADA), HHSC and DSHS 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.
Pre-Employment Checks And Work Eligibility
Depending on the program area and position requirements, applicants selected for hire may be required to pass background and other due diligence checks.
HHSC uses E-Verify. You must bring your I-9 documentation with you on your first day of work. Download the I-9 Form
Nearest Major Market: Austin
Salary : $3,581 - $4,198
