Ombudsman Liason - Program Manager

Anticipated End Date:

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Job Description:

Ombudsman Liaison - Program Manager

#HealthyBlueCareTogetherCFSP

We are partnering with North Carolina DHHS to operationalize a statewide Medicaid Plan designed to support Medicaid-enrolled infants, children, youth, young adults, and families served by the child welfare system so that they receive seamless, integrated, and coordinated health care. Within the Children and Families Specialty Plan (CFSP), and regardless of where a member lives, they will have access to the same basic benefits and services, including Physical health, Behavioral health, Pharmacy, Intellectual/Developmental Disabilities (I/DD) services, long term services and supports, Unmet health-related resource needs, and Integrated care management. We envision a North Carolina where all children and families thrive in safe, stable, and nurturing homes.

This position is responsible for coordinating services with local community organizations and working with local advocacy organizations to assure that the Children and Families Specialty Plan (CFSP) members have access to Covered Services and non-covered services. This position plays a crucial role in supporting individuals and families by educating and navigating stakeholders on the CFSP Foster Care program and its benefits. You will utilize your professional expertise, experience within the NC System of Care and exceptional communication skills to address inquiries

Location: North Carolina residency is required!

HOURS: General business hours, Monday through Friday.

TRAVEL: Travel to various regions within NC may be required. When you are not in the field, you will work virtually from your home.

Field: This field-based role enables associates to primarily operate in the field, traveling to client sites or designated locations as their role requires, with occasional office attendance for meetings or training. This approach ensures flexibility, responsiveness to client needs, and direct, hands-on engagement. 

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. 

The Ombudsman Liaison - Program Manager is responsible for the development and ongoing management of one or more multi-year external client facing programs within a business unit. Program managers typically support business strategies through an integrated portfolio of external client facing projects or initiatives. A program manager may have responsibility for a piece of a larger enterprise/regional external client facing program.

How you will make an impact:

• Develops and executes statewide ombudsman strategy for the NC Children and Families Specialty Plan (Healthy Blue Care Together) through strategic planning, collaborations, and strategic alliances. Improves understanding of local advocacy organizations, philosophies, stakeholders, legislators and providers that interact with or influence members and policy. Serves as an informal information resource, communication channel, complaint handler, facilitator, consultant, and practitioner for dispute resolution. Seeks fair/equitable solutions to member/provider problems.

• Recommends dispute resolution processes to address and manage conflicts; recommends policy and procedural changes.

• Brings issues to health plan executive leadership to address care delivery improvement efforts and promote effective relationships/communication between members and providers.

• Manages and coordinates the development, approval, implementation and compliance of on-going external client facing programs; develops program budget; ensures program meets its stated objectives; provides subject matter expertise in response to day to day external client facing business issues.

• Researches applicable subject matter practices and remains aware of industry trends.

• Manages external client facing relationships and partners with corporate and regional business areas.

• Coordinates training related to external client facing program; develops program success measures and performs periodic assessments of program success.

Minimum Requirements:

Requires a BA/BS and minimum of 5 years external client facing experience in program/project management; or any combination of education and experience, which would provide an equivalent background. Graduate degree preferred.

Preferred Skills, Capabilities and Experiences:  

• Project management certification preferred.

• Graduate degree preferred.

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Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process should submit the following form: Accessibility Accommodation Request Form and a member of the team will be in contact. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.

Prospective employees required to be screened under Florida law should review the education and awareness resources at HB531 | Florida Agency for Health Care Administration.

NOTE: Workday keeps job postings active through 11:59:59 PM on the day before the listed end date. Example: If the end date is 3/13, the posting will automatically come down on 3/12 at 11:59:59 PM. In other words — the job is posted until 3/13, not through 3/13.