SENIOR HUMAN SERVICES PROGRAM SPECIALIST

Senior Human Services Program Specialist

This is an exciting opportunity to help shape the quality of health care in Florida. We are seeking to hire a Senior Human Services Program Specialist who desires to work to enhance the delivery of health care services through the Florida Medicaid Program. This position requires a candidate who is creative, flexible, innovative, and who will thrive in a fast-paced, team based work environment. This is a professional position in the Medicaid Helpline Contact Center, within the Bureau for Recipient and Provider Assistance (RPA) within the Division of Medicaid, Agency for Health Care Administration (Agency). The incumbent in this position performs professional work in the Medicaid Contact Center, which includes performing as a Choice Counselor for the Statewide Medicaid Managed Care (SMMC) programs and attending Medicaid RPA Outreach events.

The incumbent in this position answers an ongoing pro-rata share of recipient, provider and escalation calls, per the need of the Agency, and assignments, including assigned tasks, special projects and initiatives, as assigned, and to meet established performance measures and contact center metrics. The incumbent maintains high quality and professional consumer service standards, handles all calls with respect and dignity, listens carefully, maintains confidentiality, and provides unbiased information. In the role of Choice Counselor, provides unbiased education and assistance when enrolling potential enrollees into a participating Health Plan and PCP provider as requested.

The incumbent answers questions and educates Medicaid recipients and the general public in a timely, unbiased manner about the (SMMC) programs, Medicaid covered services, and available Health Plan choices. The incumbent enters all enrollment activity and logs all interactions into the appropriate system (i.e., Health Track), using the correct documentation and call reasons. S/He arranges for necessary translation assistance at the time of call, including: TDD or TYY and Interpreter Vendor services. Complaints, requests for fair hearings, and escalation issues, etc. are referred timely and appropriately. Maintains up to date knowledge concerning the Florida Medicaid Program; pertinent federal laws and regulations, state statutes and rules; the Florida Medicaid State Plan and its amendment processes; Medicaid Managed Care Waivers; and Medicaid program manuals.

This position is not a remote or telework position.

Benefits of Working for the State of Florida: Working for the State of Florida is more than a paycheck. We offer an excellent array of benefits, including: health insurance (i.e., individual and family coverage) to eligible employees, life insurance; $25,000 policy is free plus option to purchase additional life insurance, dental, vision and supplemental insurance, State of Florida retirement options, including employer contributions, ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida, ability to earn up to 104 hours of sick leave annually, nine paid holidays and 1 personal holiday each year, opportunities for career advancement, tuition waivers (accepted by major Florida Colleges/universities), student loan forgiveness opportunities (eligibility required), training opportunities, flexible spending accounts, shared savings program for select medical services, lower copays for prescription drugs, health and wellness discounts.

Knowledge, Skills, and Abilities Knowledge of, or ability to learn, detailed Medicaid policies and procedures. Knowledge of, or ability to learn, Statewide Medicaid Managed Care programs (MMA, LTC, and F-F-S, etc.). Knowledge of, or ability to learn, Contact Center policies and procedures, including Choice Counseling. Knowledge of, or ability to learn, several computer-based systems and programs such as HT, FMMIS, Genesys, Outlook, Excel, Word, SharePoint, People First, etc. Basic knowledge of medical terminology. Knowledge of correct spelling, grammar, and punctuation. Excellent communication skills, both verbal and in writing, including skills listening, understanding, and explaining complex, technical, or confidential information. Efficient time management, organizational, and multi-tasking skills. Professional interpersonal skills in both one-on-one and in group settings. Professional telephony skills in a high call volume setting. Proficient computer typing and/or keyboarding skills. Analytical and problem-solving skills. Abilities to meet deadlines and to work well under pressure. Ability to handle sensitive information and adhere to confidentiality requirements. Ability to follow instructions. Ability to learn and to apply knowledge. Ability to adapt to changes. Ability to maintain professional and effective working relationships. Ability to travel with or without accommodation.

Minimum Qualifications Requirements Two years of experience providing a professional level of customer service in a fast-paced consumer centric environment. Preference will be given to the applicant that has: moderate to extensive experience and abilities using different computer programs such as Excel, Outlook, and Word, etc., including quick and accurate typing/keyboarding skills. Six months experience in a Medicaid call center or high-volume setting. Bilingual (English/ Spanish) language skills preferred.

Contact: Tiffany Trinidad View phone number on click.appcast.io