GOVERNOR'S CONSUMER HEALTH ADVOCATE - UNCLASSIFIED

The Office for Consumer Health Assistance (OCHA) helps Nevada residents navigate the health care system by assisting consumers in understanding their rights under health plans and workers’ compensation. The office supports individuals in filing medical and dental appeals, submitting quality of care complaints, and accessing health care resources, especially for the uninsured and underinsured. OCHA guides injured workers through the workers’ compensation process, identifies financial assistance programs, facilitates the external review process by assigning independent review organizations, and conducts arbitrations for certain emergency service billing disputes. Through the Bureau for Hospital Patients, OCHA also assists consumers with hospital related billing and access issues as outlined in NRS 232.462. The office maintains strong relationships with insurers, providers, social services, and government agencies while staying current on health care laws, policies, and industry trends to ensure consumers receive fair, informed support.

• Must hold a degree from an accredited college or university. Preference is given to candidates with degrees in: Health, Social Science, Public Administration, Business Administration or a related field.

• Must have no less than 3 years of experience in the administration of health care or insurance programs.

• Must have expertise and experience in the field of advocacy

The Governor’s Consumer Health Advocate leads the statewide efforts of the Office for Consumer Health Assistance (OCHA) to protect consumer health rights, improve access to care, and ensure Nevadans receive fair treatment within the health care and workers’ compensation systems. This role serves as the primary liaison between the public and state government, shaping policy, guiding strategic initiatives, and overseeing programs that help consumers navigate complex insurance, billing, and care access challenges.

Day-to-Day Responsibilities:

• Oversee daily operations of OCHA’s programs, including the Ombudsman program, Community Advocate program, and the Bureau for Hospital Patients.

• Ensure compliance with state laws, regulations, and reporting requirements related to consumer health assistance.

• Provide leadership and guidance to staff assisting consumers with insurance appeals, quality of care complaints, workers’ compensation issues, and access to care concerns.

• Facilitate the State of Nevada External Review Process by assigning independent review organizations for adverse benefit determinations.

• Oversee binding arbitrations between out of network providers and health plans for emergency service claims under $5,000.

• Build and maintain collaborative relationships with insurers, health care providers, social service agencies, and government partners.

• Monitor trends in health care policy, insurance practices, and consumer needs to inform program improvements and statewide initiatives.

• Represent consumer interests in discussions with policymakers, agencies, and stakeholders to advance equitable access to health care.

Hard Skills:

• Health care policy knowledge

• Health insurance carrier operations

• Provider/facility billing and claims experience

• Workers’ compensation system knowledge

• Regulatory and statutory compliance

• External review process administration

• Arbitration or dispute resolution procedures

• Data analysis and trend identification

• Report writing and documentation

• Program and project management

• Public agency operations

• Stakeholder and interagency coordination

• Understanding of hospital billing and patient rights (NRS 232.462)

Soft Skills:

• Strong communication and public facing skills

• Empathy and consumer focused mindset

• Critical thinking and problem solving

• Diplomacy and conflict resolution

• Leadership and team guidance

• Integrity and ethical decision making

• Ability to remain neutral and objective

• Relationship building and collaboration

• Adaptability and resilience

• Sound judgment under pressure

• Attention to detail

• Professionalism and discretion