The BCBSVT Member Ombudsman’s primary responsibility is to promote and protect the interests of members under their health plans.  This will include working with members and external groups to further BCBSVT’s mission to provide outstanding member experiences and generally convey the image that “we’re different” from others in our industry.  The Ombudsman will provide confidential, neutral assistance to our members and will advocate for fairness, serving as a source of information and support and acting as a conduit between conflicting parties.  The Ombudsman will also answer questions regarding members’ health benefits and assist individuals in understanding how their health benefit plans function.  The Ombudsman will be able to explain to individuals various regulatory requirements that BCBSVT must comply with and respond to questions about laws relating to BCBSVT.  Generally, the Ombudsman will provide member assistance after the member has attempted to work through standard BCBSVT procedures and channels and still requires additional assistance.  The Ombudsman will conduct consumer outreach efforts so that members are aware of how the Ombudsman can provide assistance.  The Ombudsman will work with BCBSVT internal departments to address recurring member issues and, where feasible, change programs or processes to prevent future occurrences.  The Ombudsman will work directly with the CEO on member experience issues and to support external engagements, e.g., BCBSVT’s community meetings, member focus groups, etc.

Qualifications:

• BA/BS or equivalent required.

• 5 - 7 years of experience in health care or health insurance setting, with a solid understanding of health insurance products.