Department Information

The purpose of the work unit.:
The role of the Ombudsman office is to:
1. Interact with consumers and healthcare providers with concerns or complaints to help them resolve behavioral healthcare access and coverage and coverage issues.

2. Identify, track, and report to the appropriate regulatory or oversight agency concerns, complaints, and potential violations of state or federal rules, regulations, or statutes concerning the availability of, and terms and conditions of, benefits for mental health conditions or substance use disorders, including potential violations related to quantitative and non-quantitative treatment limitations.

3. Receive and assist consumers and providers in reporting concerns and filing complaints with appropriate regulatory or oversight agencies relating to inappropriate care, an emergency procedure under section 27-65-105, a certification for short-term treatment under section 27-65-107, or a certification for long-term care and treatment under section 27-65-109.

4. Provide appropriate information to help consumers obtain behavioral health care.

5. Develop appropriate points of contact for referrals to other state and federal agencies.

6. Provide appropriate information to help consumers or health care providers file appeals or complaints with the appropriate entities, including insurers and other state and federal agencies.

Description of Job

This position is responsible for developing, directing, and planning the objectives of the Office in tandem with the Appointed Ombudsman and has shared accountability for the implementation of these objectives. The co-Ombudsman is an analytical and strategic position with internal and external facing planning and complex decision-making responsibilities, providing oversight to activities addressing access to behavioral health care, public policy, and strategic planning for the Office. The co-Ombudsman engages directly with the community and conducts analyses and reports on concerns, complaints, and potential violations of state and federal mental health parity laws and regulations. The position requires experience in and extensive knowledge of Colorado’s public and private behavioral health care system and Ombudsman functions. The position provides expertise regarding regulations and statutes related to access to behavioral health care, including a deep understanding of a behavioral health continuum of care and insurance responsibilities related to mental health parity.

Summary of Duties:

Strategic and operational planning:
The co-Ombudsman for Strategy and Operations leads the Office in long-term planning, establishing outcomes and clear project plans, and serves as a liaison with the Office of the Governor, the Ombudsman Liaison, and the Commissioner of the Division of Insurance within the Department of Regulatory Agencies, the Ombudsman Liaison and the Commissioner within the Behavioral Health Administration (BHA), other state agencies, non-governmental entities, federal government, consumers, behavioral health providers, insurers, and others as needed to ensure the functioning of the Office and implementation of its responsibilities. This position responds to communications from the public requesting information about behavioral health access to care or populations in need of behavioral health care services and would rely upon knowledge, skills, and experience to answer the question or provide the information. This position reviews Office resources and functioning and makes complex decisions regarding proposals for sustainability and long-term strategy.

Systems and process management :
This position oversees strategic Office functions, operational standards and implementation, intake processes, reporting and data collection processes, and maintains internal operational functioning with other staff and the Appointed Ombudsman. The co-Ombudsman for Strategy and Operations may provide guidance and oversight to the intake coordinator and/or case management position(s)on a needed basis.

Policy development : This position will oversee high-level Office functions, budget, operational standards, and implementation, intake processes, reporting and data collection processes, and will also maintain internal operational functioning with the Appointed Ombudsman. The co-Ombudsman will supervise intake coordinator position(s) and contracts and contract workers. This position reviews Office resources and functioning and makes complex decisions regarding proposals for sustainability and long-term strategy.

Branding and outreach:
The position assesses the reach of the Office and makes decisions regarding outreach needs and works with the Appointed Ombudsman and any relevant state entities on branding and marketing the Office to ensure the Office is known, understood, and accessible. Serves as a community representative on stakeholder committees, attending meetings, and providing advice and recommendations for the maintenance and improvement of effective behavioral health programs and services; advocates against policy or actions that may adversely affect the health, safety, welfare, or rights of patients

Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights

Minimum Qualifications:
Bachelor's degree from an accredited institution in a field of study related to the work assignment.
AND

Additional appropriate experience will substitute for the degree requirement on a year-for-year basis.

Additional appropriate education will substitute for the required general experience on a year-for-year basis, but not the two (2) years of specific experience.

Highly Desirable Qualifications:

• At least 10 years of progressively responsible professional experience in public policy and policy research, including at least 3 years in a director-level position
• At least 5 years of professional experience in behavioral healthcare policy or research
• Professional experience in a behavioral health ombudsman office
• Direct experience advising on strategic operations and budget of a state-level office
• Direct experience identifying, tracking, analyzing, and assessing data related to state or federal mental health coverage and parity rules, regulations, and statutes, including nonquantitative treatment limitations (NQTLs)
• Direct high-level behavioral health systems policy experience, including providing subject matter expertise to state legislators/officials and working directly with insurance carriers and behavioral health providers or groups of providers on behavioral health policy and regulations
• Experience producing statutorily required annual reports and other high-level behavioral health policy and research-related communications

Conditions of Employment:

The successful candidate in this position must be willing and available to submit to the following conditions:

• Standard Background – Name check, TRAILS, CMS and JBITS
• Travel – This position may need to travel occasionally out of town on an irregular estimated monthly frequency as individual situations require.
• As a condition of employment, this position is required to attest to and verify that they are fully vaccinated for COVID-19 or submit to twice-weekly serial testing. On or after October 31, 2021, each facility shall ensure all newly hired employees, direct contractors, or support staff members are fully vaccinated at the time of hire, or receive their first dose of a two-dose protocol, or a single-dose vaccination, prior to providing any care, treatment, or other services for the facility and/or its clients.

Supplemental Information

• Strong, secure, yet flexible retirement benefits including a PERA Defined Benefit Plan or PERA Defined Contribution Plan www.copera.org plus 401(k) and 457 plans
• Medical and dental health plans
• Employer supplemented Health Savings Account
• Paid life insurance
• Short- and long-term disability coverage
• 11 paid holidays per year plus vacation and sick leave
• BenefitHub state employee discount program
• Employee Wellness program MotivateMe
• Excellent work-life programs, such as flexible schedules, training and more

• Remote work arrangements for eligible positions

• 
  Some positions may qualify for the Public Service Loan Forgiveness Program. For more

Independent: We operate independently from all of Colorado's governmental agencies, insurance carriers, and behavioral health providers. We serve the people of Colorado.

Neutral: We act as an impartial receiver of concerns, complaints and data, and have a statutory mandate to maintain transparency and report on our work to the public.

Confidential: We do not disclose any identifying information without permission unless it is necessary to address imminent risk of serious harm.

Inclusive: We believe that this office needs to be available to all residents of Colorado regardless of insurance coverage. We seek to be a safe and accessible space for persons of any ability or identity.

We are committed to increasing the diversity of our staff and providing culturally responsive programs and services. Therefore, we encourage responses from people of diverse backgrounds and abilities.

ADAA Accommodations: CDHS is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Nancy Schmelzer, at cdhs_ada@state.co.us or call 1-800-929-0791.

~THE STATE OF COLORADO IS AN EQUAL OPPORTUNITY EMPLOYER~