Ombudsman Services Specialist

Job Title

The Department administers numerous benefit programs for current, inactive, and retired public employees. The benefit programs include the Wisconsin Retirement System, group health insurance, group life insurance, deferred compensation, employee reimbursement account, income continuation insurance, long-term disability insurance, duty disability, and long-term care insurance.

Qualifications

The candidate for this position must currently reside within Wisconsin the position is primarily remote; they do have an option to work onsite if desired. We are planning two rounds of interviews for qualified candidates. An exceptional candidate will be able to effectively prioritize their workload and make independent decisions after initial training. They must have knowledge of philosophy, principles, and practices of health insurance, life insurance, income continuation insurance, and Wisconsin Retirement System programs. In addition, knowledge of state and federal laws, rules and regulations governing Medicare and Medicare supplement programs. Other qualifications include:

• Ability to use computer applications to create effective letters, spreadsheets, and reports.
• Effective human relation skills.
• Oral and written communication skills.
• Knowledge of public relations and public speaking fundamentals.
• Knowledge of negotiation methods and techniques.
• Knowledge of complaint and problem resolution techniques.
• Knowledge of advocacy techniques.
• Knowledge of interviewing and investigation processes and techniques.
• Knowledge of research and analysis methods and techniques.
• Knowledge of statistical gathering techniques and analysis.
• Knowledge of information systems and data processing.
• Knowledge of quality improvement and reengineering philosophy and techniques.
• Knowledge of survey development implementation and analysis methods.
• Knowledge of effective training and education techniques.
• Ability to design and market effective educational and informational materials.
• Knowledge of health care delivery systems.
• Knowledge of benefit plan grievance and appeal processes.

What We Are Looking For

The Ombudspersons Services team is seeking a candidate with a strong background in health insurance, life insurance, income continuation insurance, and Wisconsin Retirement System programs. In addition, knowledge of state and federal laws, rules and regulations governing Medicare and Medicare supplement programs. The majority of an Ombudsperson's work involves resolving disputes with benefit plans on behalf of participants. Through this process, the Ombudsperson often must negotiate changes in policy, practice, or benefit provision interpretations with insurance plans, third-party administrators, and Department staff. If unable to resolve a complaint, the Ombudsperson advises the participant on the remaining options.