KanCare Ombudsman Volunteer Application

The KanCare Ombudsman Volunteer Program will have trained volunteers answering calls and meeting with people in the office who have questions about KanCare. They will be able to answer Medicaid questions, help resolve problems and refer members to resources. The program will start in the more urban areas of Kansas (Kansas City Metro and Wichita) and future areas will be added as indicated by need.

All applicants for the KanCare Ombudsman Volunteer Program must complete and sign the application and the background check forms when applying to the program. If a person with a disability requires auxiliary aides and services when completing this application, please contact the KanCare Volunteer Ombudsman’s office to make that request.

Fluent in any language other than English?

Spanish
French
Chinese
Russian
Other

If other, please specify:

This position requires approximately 3 to 10 hours of volunteer service weekly between the hours of 9 am - 5 pm in the Wichita office or 10 am - 4 pm in the Olathe office. What is your availability?

Are you a college student?

Yes
No

Are you employed?

Yes
No

If "yes," what college or university?

If "no," enter N/A

If yes, name of employer(s)?

If "no," enter N/A

This position requires use of a personal computer, Microsoft Office Products (Word, Excel, Outlook email, etc.), the Internet, email and telephone. What is your experience with this equipment, service and software?

Tell us about your work and / or volunteer experience.

Tell us why you are interested in being a KanCare Ombudsman Volunteer.

Please describe your experience helping people who have problems with or questions about government programs or services (could be KanCare or some other program).

Are you or have you been affiliated with any of the following organizations or companies? Are you in or have been in a relationship with any of the following? Are you or have you ever been employed as any of the following? Check all that apply.

Amerigroup
United HealthCare
Sunflower Health
Disability Rights Center
KanCare Recipient
Kansas Legal Services
Targeted Case Manager
Not Applicable

Declaration:

I declare that the information provided and statements made in this application are true and complete to the best of my knowledge and belief. I also declare that I understand that the purpose of the training I receive as a KanCare Ombudsman Volunteer is to provide services free to charge of people with Medicaid and is not to be used for my personal or professional gain.

Electronic Signature

Type full name

Date

For questions about filling out the background check forms call Lisa Churchill at 785-296-2081.

This is what you can expect to happen next:

The Volunteer Coordinator will review your application then call you to set up an interview.
If the volunteer service position is a good fit for both the volunteer and the KanCare Ombudsman office, a background check will be completed next.
Once you have passed the background check, you will receive information for the initial training and a schedule of the training sessions.

Volunteer Program Online Application