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CMS Leadership

Medicare Ombudsman Group

Daniel Schreiner, Director

Division of Medicare Ombudsman Assistance - Belen Rodriguez, Director
Division of Ombudsman Research and Trends Analysis - Nicole Jones, Acting Director
Division of Ombudsman Exceptions - Bruce Miller, Director

Functional Statement

  • As the Medicare Beneficiary Ombudsman, provide guidance to the Agency to identify and resolve systemic issues in order to provide assistance to individuals entitled to benefits under Title XVIII. Assesses Medicare program policy and operations and the impact on beneficiaries in order to affect positive change in the manner in which we provide customer service to people with Medicare. Make recommendations for improvements to CMS leadership and through an annual report to Congress.
  • Receives, analyzes, monitors, and reports on beneficiary inquiry/complaint data, trends and performance of Medicare beneficiary programs in coordination with all CMS components that receive and track beneficiary inquiries and complaint information.
  • Maintains data from information management systems and communicates findings to Agency partners to confirm program performance expectations of CMS beneficiary assistance programs and to support the recommendations for program improvements.
  • Develops programs, activities, and initiatives to track issues impacting beneficiaries and provide Continuous Quality Improvement mechanisms to analyze program challenges; develops Agency cross-cutting teams to facilitate improvements.
  • Provides guidance to CMS components to incorporate consistent performance measures into existing beneficiary programs.
  • Facilitates case receipt, triage, analysis, and resolution for beneficiaries, caregivers, congressional staff, and senior HHS/CMS staff.
  • Evaluates and makes exceptions to CMS policies impacting Medicare beneficiaries on a case by case basis.
  • Manages the operations of Medicare beneficiary casework in partnership with other CMS central and regional office components in order to develop and implement casework improvement strategies.
  • Serves the beneficiary population as the Federal level Ombudsman in all aspects of the Medicare program including rights and protections. Coordinates with the OEA partnership group in working with external advocacy groups to ensure program improvements are identified and the beneficiary's perspective is represented.
  • Coordinates with Strategic Research & Campaign Management Group (training, the State Health Insurance Programs (SHIPs), partnership) to strengthen SHIPs to improve information and assistance.
  • Supports the Partner Relations Group in coalition building and maintaining relationships with beneficiary advocacy groups and other partners to continuously improve CMS processes to better serve Medicare beneficiaries.
  • Ensures that activities and initiatives are aligned with the objectives of the Agency's Strategic Action Plan and establishes appropriate measures to assess and track success in meeting objectives.


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Page Last Modified: 07/25/2008 2:29:57 PM
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