Ombudsman and Medicaid Attorneys (2)
Pisgah Legal Services (PLS) is a community-based non-profit legal aid agency governed by a local Board of Directors. PLS has an annual budget of $7.5 million from a multitude of funding sources. Located in the Blue Ridge Mountains of Western North Carolina (WNC), Pisgah Legal Services’ provides free civil legal assistance to low-income people in WNC. The organization currently has offices in Asheville, Hendersonville, Highlands-Cashiers, Rutherfordton, Brevard, Burnsville, and Marshall. With a dedicated staff of 85, including thirty-six attorneys plus program staff, and an active group of 300 volunteer attorneys, the program provides free services to more than 18,000 people per year to meet their basic needs, primarily in the poverty law areas of housing, public benefits, domestic violence prevention, health care, immigration, and consumer law.
The Ombudsman Program Attorney will:
• Represent and advise clients in judicial and administrative hearings in healthcare cases, primarily with Medicaid, handling a geographically and substantively diverse caseload.
• Conduct trauma-informed and client-centered interviews with a holistic approach to poverty law remedies;
• Advise and represent clients in legal proceedings as appropriate. This may include representation at informal and formal hearings, negotiations, and other types of direct case representation applicable to Medicaid and the managed care system;
• Maintain meticulous and contemporaneous records, and document all work in Legal Server case management software;
• Develop and maintain relationships with communities and other non-profit agencies, government officials, government employees, community leaders and others;
• Adhere to program priorities and case handling policies, procedures and standards of practice, as well as the highest professional and ethical standards;
• Keep abreast of developments in the law and disseminate information to staff, volunteer attorneys and the public;
• Assist low-income families by telephone, online and in-person (under COVID-19 restrictions and safety measures) to access and use health care coverage under Medicaid and in resolving disputes with Medicaid health insurance plans;
• Assist with outreach to educate families of available coverage choices and their rights under Medicaid;
• Provide referrals to appropriate agencies for applicants and enrollees with grievances, complaints, questions, or need for other social services;
• Document and enter data into a case management system to assist with identifying trends and systemic issues;
• Provide all information and services in a manner that is culturally and linguistically appropriate and ensure accessibility for individuals with disabilities; and
• Work with English and Spanish language media (including print, radio and television) to share information on Ombudsman services and the availability of assistance.
• N.C. Licensed attorney
• Knowledge and understanding of the NC Medicaid System and NC Prepaid Health Plans preferred
• Demonstrated skills at socio-economic and cultural sensitivity, commitment to equity
• Commitment to work collaboratively with all constituent groups, including staff, consumers, clients, board members, donors, community groups, member organizations and others
• Self-motivated, able to work independently
• Detail-oriented, accurate and organized
• Ability to create, communicate, understand, remember, and carry out complex instructions
• Excellent writing and verbal communication skills
• Strong interpersonal skills and the ability to work well with teams
• Proficiency in MS Office, including Word, Excel, Power Point and Adobe PDF professional; experience with Legal Server Case Manage software preferred.
• Ability to effectively communicate and collaborate with co-workers and clients in virtual, face to face and meeting settings.
• Available for Ombudsman Schedule, 8 am- 5pm daily, Monday-Friday except NC State holidays.
• Access to a reliable car with car insurance and have a valid driver’s license preferred;
• Able to work nights and/or weekends during high demand periods preferred;
• Possess socio-economic and cultural sensitivity and ability to communicate with persons in crisis or under stress; and
• Ability to multi-task and interact well with professionals, clients, and others.
Salary ranges from $49,616 – $94,116 depending on experience. Excellent fringe benefits, including 401(k) retirement plan, as well as life, health, and disability insurance.
E-mail resumé and cover letter describing relevant experience to [email protected]. PLS invites all applicants to include in their cover letter a statement about how your unique background and/or experiences might contribute to the diversity, cultural vitality, and perspective of our staff and legal services practice.
Pisgah Legal Services is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status