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 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.

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:

• 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 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.

Contact: Emily Hughart View phone number on click.appcast.io/ Janice Colquitt View phone number on click.appcast.io