SENIOR HUMAN SERVICES PROGRAM SPECIALIST

Requisition No: 877681


Agency: Agency for Health Care Administration

Working Title: 68058971 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST

Pay Plan: Career Service

Position Number: 68058971


Salary: $1,636.98 - $2,128.07 Biweekly


Posting Closing Date: 06/25/2026


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Agency Overview:

The Agency for Health Care Administration (AHCA) is Florida's chief health policy and planning entity.


The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, and empowering consumers through health care transparency initiatives.


Under the direction of the Agency Secretary, AHCA is focused on advancing Governor DeSantis' vision for Florida's health care system to be the most cost-effective, transparent, and high-quality health care system in the nation.


The Medicaid program provides low-income families and individuals with access to health care.


If you have a desire to use your talent and skills at an organization that provides critical services to millions of individuals and families across the state, AHCA invites you to apply to become an essential member of our team.


As one of Florida's leading state agencies, AHCA's diverse workforce community of more than 1,400 employees is proud of its efforts to serve the people of Florida.

Agency Objectives:

HIGH QUALITY

Emphasizing quality in all that we do to improve health outcomes, always putting the individual first.

TRANSPARENT

Supporting initiatives that promote transparency and empower consumers in making well informed healthcare decisions.

COST-EFFECTIVE

Leveraging Florida's buying power in delivering high quality care at the lowest cost to taxpayers.

Position Overview:

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 position is located in the Bureau of Medicaid Recipient and Provider Assistance (RPA).


RPA serves as a primary point of contact for enrolled Medicaid providers, Medicaid recipients, and members of the community with questions and concerns about Medicaid.

This position is responsible for researching and responding to recipient issues and concerns, as well as providing technical assistance to help recipients understand Medicaid coverage policy and assure that recipients receive proper care.


The individual in this position is also responsible for researching and responding to recipient requests for assistance and for Recipient Enrollment Support Center functions.

A good attendance record is essential for any individual in this position as the work involved occurs daily and is time sensitive. The individual in this position is expected to report to work daily and on time.

Examples of work include, but are not limited to:

Receive, research, and respond to county code errors, unable to locate, segment updates, Third Party Liability (TPL) file maintenance requests, and other file problems.

Research errors using FMMIS, FLORIDA, and Health Track.

Remain informed about Medicare and other federal and state health care related programs.

Research, resolve, and respond to Medicare premium payment issues, changes to Medicare Part A and B coverage, and corrections to Medicare numbers.

Communicate with Headquarters, Department of Children and Families (DCF), Social Security Administration (SSA), Statewide Medicaid Managed Care (SMMC) plans, and Medicaid recipients in order to resolve assistance requests.

Work with providers to resolve complex recipient issues.

Research, resolve, and respond to beneficiary billing issues and concerns Provider Choice Counseling assistance to Medicaid recipients Explain the differences between partial Medicaid programs, Fee-For-Service (FFS), and SMMC.

Receive and respond to inquires and requests for assistance in order to help navigate the Medicaid health care system.

Respond to questions related to Medicaid applications and eligibility status, referring to DCF or SSA when appropriate.

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

For a more complete list of benefits, please visit

For more information about the Bureau of Medicaid Recipient and Provider Assistance, please visit our website at

Join us at the Agency for Health Care Administration in fulfilling our mission to provide "Better Health Care for all Floridians."

KNOWLEDGE, SKILLS, AND ABILITIES

Knowledge of the Medicaid arena, Medicaid policies, and Medicaid procedures

Skills to utilize computer equipment/software and analyze data

Ability to perform effectively in stressful situations

Ability to communicate effectively, verbally and in writing


Ability to utilize problem-solving techniques

Ability to plan, organize, and coordinate work assignments

Skill to provide customer service

Ability to establish and maintain effective working relationships

Ability to provide training to providers, recipients, coworkers, community agencies, and the general public

Ability to travel with or without accommodations

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.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT: EMILY HUGHART View phone number on click.appcast.io/ JANICE COLQUITT View phone number on click.appcast.io

BACKGROUND SCREENING

It is the policy of the Florida Agency for Health Care Administration that any applicant being considered for employment must successfully complete a State and National criminal history check as a condition of employment before beginning employment, and, if applicable, also be screened in accordance with the requirements of Chapter 435, F.S., and Chapter 408, F.S. No applicant may begin employment until the background screening results are received, reviewed for any disqualifying offenses, and approved by the Agency. Background screening shall include, but not be limited to, fingerprinting for State and Federal criminal records checks through the Florida Department of Law Enforcement (FDLE) and Federal Bureau of Investigation (FBI) and may include local criminal history checks through local law enforcement agencies.

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center View phone number on click.appcast.io). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

VETERANS' PREFERENCE. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans' Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans' Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.


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