The Transportation Provider Ombudsman is MTM’s designated Provider advocate responsible for investigating and resolving complaints in accordance with client requirements and MTM Policies and Procedures. The Transportation Provider Ombudsman is responsible for Quality Management to ensure the best service to its members and clients. This position is contingent on award of contract. Location: South Carolina. Responsibilities include serving as the primary point-of-contact for providers on escalated issues; documenting, reviewing, investigating, and providing follow-ups for all complaints and complaint issues reported by Providers; triaging issues, complaints & unusual trip circumstances and determining appropriate action by reviewing complaint history, trip history, etc.; assisting and advocating on behalf of Providers, including working directly and collaboratively with internal departments regarding complaints and processes; providing complaint escalation investigation and sending complaint escalation resolution letters to Providers per client contract; determining disciplinary action based on conducted investigation; crafting well-written, researched and provider focused responses; maintaining a working knowledge of Transportation Provider contract and operational policies and procedures; providing immediate follow-up for Provider complaint responses that are not submitted within the specified timeframe and enforcing disciplinary measures as needed; attending client meetings both on and offsite as needed; coordinating vendor education and disciplinary measures given in response to appeals and complaint escalations with Quality / Network Management; responding to client, Program Manager, Transportation Manager or Account Manager inquiries sent via email, or fax, within the specified timeframe; maintaining a working knowledge and understanding of client protocols and RFP; providing investigation for denial of service and sending resolution letters to Providers per client contract; using complaint data to recommend and implement education and process improvement; compiling weekly/monthly interaction reports for leadership; tracking and trending provider complaints and complaint escalations; assisting Quality/Account Executives/Program Directors/ETOs with complaint issues; updating Network Management in regard to non-compliance issues with transportation providers and advising of incident/accident issues as needed; communicating with Call Center leadership with regards to provider complaints; and other duties as assigned. Requirements include High School Diploma or G.E.D., Bachelor’s degree preferred, typing speed of 30 WPM or greater, one year of customer service experience, experience resolving customer complaints, intermediate proficiency with Microsoft Word and Excel, excellent communication skills, strong organizational and time management skills, ability to handle confidential information professionally, superior problem-solving skills, and a high level of professionalism and positive attitude. Preferred qualifications include previous Quality Management experience, Health Care experience, and member advocacy experience.
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