68022240 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST

68022240 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST

Agency: Agency for Health Care Administration Location: Florida Position is not remote or telework. Position Overview Assist in managing the Florida Medicaid Program as a Choice Counselor at the Medicaid Helpline Contact Center. The role involves answering recipient and provider calls, enrolling individuals into managed care plans, providing unbiased education, handling complaints, and maintaining accurate logs in Health Track. Key Responsibilities Answer a pro‑rata share of recipient, provider, and escalation calls, meeting established performance measures and contact center metrics. Provide unbiased education and assistance when enrolling potential enrollees into participating Health Plans and primary care providers. Verify identity, explain available plans, and help navigate enrollment periods and open enrollment. Assist enrollees in resolving complaints and grievances through direct intervention, referral, or escalation. Enter all enrollment activity and log interactions into Health Track using correct documentation and call reasons. Arrange necessary translation assistance (TDD/TYY, interpreter services) during calls. Refer complaints, requests for fair hearings, and escalation issues timely and appropriately. Maintain up-to-date knowledge of Florida Medicaid Program policies, federal laws, state statutes, and Medicaid state plan. Participate in agency training opportunities and engage in self‑education using available resources. Qualifications & Knowledge Two years of professional customer service experience in a fast‑paced consumer‑centric environment. Experience in a Medicaid call center or high‑volume setting (minimum 6 months). Proficient computer skills: HT, FMMIS, Genesys, Outlook, Excel, Word, SharePoint, People First. Strong communication skills, both verbal and written; active listening and the ability to explain complex information. Efficient time management, organization, and multitasking in a high‑call‑volume environment. Understanding of medical terminology, HIPAA confidentiality, and basic legal terminology. Ability to handle sensitive information, meet deadlines, adapt to changes, and maintain professional relationships. Bilingual (English/Spanish) language skills preferred. Benefits Health insurance (individual and family coverage) Life insurance ($25,000 free policy with additional purchase option) Dental, vision, and supplemental insurance State of Florida retirement plan with employer contributions Up to 104 hours paid annual leave for new employees Up to 104 hours paid sick leave annually Nine paid holidays and one personal holiday per year Opportunities for career advancement Tuition waivers (accepted by major Florida colleges/universities) Student loan forgiveness opportunities (eligibility required) Shared Savings Program for select medical services Legal Notice The State of Florida is an EEO employer. Background screening, including criminal history checks, is required for all applicants before employment. #J-18808-Ljbffr State of Florida