Managed Care Specialist Ombudsman

Overview

The organization is seeking a Managed Care Specialist Ombudsman to advocate for long-term care consumers for an assigned region, with responsibilities covering Dane County and serving statewide.

All employees are expected to live and work in Wisconsin. This role involves regular travel within an assigned county or geographic area and may require travel statewide. Work is performed from home; when travel is not needed, the employee’s home will be designated as their headquarters city. The work schedule is Monday – Friday.

This position serves as the primary representative and advocate for long-term care consumers under close supervision of the Ombudsman Services Supervisor.

Responsibilities

Core responsibilities include:

• Conduct professional investigations of complaints pursuant to the Federal Older Americans Act (OAA), Section 712, related to the care and treatment of individuals residing in long-term care facilities, including:
  • Nursing homes
  • Community-based residential facilities
  • Residential care apartment complexes
  • Adult family homes
• Conduct professional investigations of complaints related to services provided to older adults under the Family Care/PACE/Partnership/IRIS Medicaid waiver programs.
• Participate in Title XVIII and Title XIX certification surveys, as specified by federal law.
• Provide representation of residents and consumers at hearings and appeals of long-term care services before the Office of Administrative Hearings and before other appropriate bodies.
• Provide education, information, outreach, and technical assistance to adults age 60 and older, their families/significant others, and providers.

Requirements

• Due to conflict of interest, persons hired for this position may not, for any reason, perform any paid or voluntary work for any long-term care, managed care, or acute care provider.
• Background checks will be conducted prior to selection.
• This organization does not sponsor work visas and is not an eligible OPT (Optional Practical Training) employer for F-1 international students.
• All persons hired must verify identity and eligibility to work in the United States and complete the required employment eligibility form.
• Regular and frequent travel is required.
• Evidence of auto insurance must be obtained prior to the selected candidate’s start date if using a personal vehicle for work.
• A valid Wisconsin driver license that meets the State’s Risk Management requirements is required to use fleet vehicles.

Qualifications

Qualified applicants will have experience with at least three of the following:

• Long-term care, aging, disability, health, or human service systems.
• Experience or knowledge of Wisconsin long-term care programs, including Family Care, PACE, Partnership, and IRIS.
• Working with older adults, people with disabilities, or other diverse populations, including supporting individuals in complex and sensitive situations.
• Individual advocacy, ombudsman services, case management, regulatory work, client rights, or a related field.
• Providing training, education, technical assistance, or information on aging, disability, or long-term care issues, such as self-direction, individual rights, confidentiality, abuse, or related topics.

In addition, well-qualified applicants will have education, training, or experience with at least one or more of the following:

• Conducting complaint investigations, including interviewing involved parties, conducting on-site visits, reviewing records or other documentation, and researching relevant requirements.
• Preparing for or representing/assisting individuals in hearings, appeals, grievances, or other formal complaint or dispute-resolution processes.
• Interpreting and applying statutes, regulations, policies, contracts, or program requirements in long-term care, health, human services, or a related setting.

Compensation & Benefits

• Starting hourly rate: $20.23–$28.72 per hour, plus excellent benefits.
• Classification: Ombudsman Services Specialist-Entry (pay schedule/range 12-64).
• Employment status: Non-exempt.
• A 12-month probationary period will be required.
• Pay for current state employees will be set in accordance with the Wisconsin State Compensation Plan.

This is the first level in the Ombudsman Services Specialist class series. Once required training and education are obtained, the incumbent will have the ability to reclass to the Ombudsman Services Specialist Objective level. It is expected that all Ombudsman Services Specialist-Entry positions will reclass to the Objective level.

Location

• Dane County with responsibilities serving statewide.
• Work from home with the employee’s home designated as the headquarters city when travel is not needed.
• Monday – Friday schedule.

Application Deadline

Applicant materials are due by 11:59pm CST on Sunday, September 27, 2026.

Additional Information

• A letter of qualifications and resume are important parts of the application and are used to evaluate how experience matches the job qualifications.
• Cover letter is limited to a maximum of two (2) typed pages, single-spaced, no smaller than 10-point font, with 1-inch margins.
• Resumes should be limited to no more than two (2) pages.
• Pages more than the specified limits may not be evaluated.

The organization is committed to providing opportunities to all applicants from all backgrounds. Reasonable accommodations are available for applicants and employees with a disability.

A special program is offered for qualified veterans with a 30% or greater service-connected disability.