68022240 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST

Requisition No: 874544 Agency: Agency for Health Care Administration Working Title: 68022240 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST Pay Plan: Career Service Position Number: 68022240 Salary: $1,636.98 - $2,128.07 Biweekly Posting Closing Date: 07/21/2026 Agency Overview The Agency for Health Care Administration (AHCA) is Florida's chief health policy and planning entity. The Agency administers the Florida Medicaid program, licenses and regulates nearly 50,000 health care facilities, and empowers 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 system in the nation. The Medicaid program provides low‑income families and individuals with access to health care. 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 health care 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 a Senior Human Services Program Specialist to enhance the delivery of health care services through the Florida Medicaid Program. The position requires a creative, flexible, innovative candidate who will thrive in a fast‑paced, team‑based environment. The role is located in the Medicaid Helpline Contact Center within the Bureau for Recipient and Provider Assistance (RPA), Division of Medicaid. The incumbent performs professional work as a Choice Counselor for Statewide Medicaid Managed Care programs and attends Medicaid RPA Outreach events. Responsibilities include answering an ongoing pro‑rated share of recipient, provider, and escalation calls, handling assignments, special projects, and initiatives to meet established performance measures and contact center metrics. The incumbent maintains high‑quality consumer service standards, listens carefully, maintains confidentiality, and provides unbiased information. In the Choice Counselor role, duties include providing unbiased education and assistance when enrolling potential enrollees, verifying identity for HIPAA confidentiality, explaining available plans and benefits, educating enrollees on enrollment periods, and mediating or resolving complaints and grievances. The incumbent enters all enrollment activity and logs all interactions into the appropriate system (Health Track), uses correct documentation and call reasons, and arranges for necessary translation assistance (TDD, TTY, interpreter vendor services). Complaints, fair hearing requests, and escalation issues are referred timely and appropriately. The incumbent must maintain up‑to‑date knowledge concerning the Florida Medicaid Program, federal laws and regulations, state statutes and rules, the Florida Medicaid State Plan, and related program manuals. The incumbent remains informed about Medicaid Managed Care Waivers, the Medicaid Fiscal Agent operations, Medicare, Medicaid, and related programs, and innovations for special populations. Continuous learning through agency training opportunities and self‑education is required. Benefits Of Working For The State Of Florida Health insurance (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 Knowledge, Skills, And Abilities Knowledge of, or ability to learn, detailed Medicaid policies and procedures, Statewide Medicaid Managed Care programs (MMA, LTC, F‑F‑S, etc.), Contact Center policies, Choice Counseling, and computer‑based systems such as HT, FMMIS, Genesys, Outlook, Excel, Word, SharePoint, People First, etc. Basic medical terminology knowledge, correct spelling, grammar, and punctuation. Excellent communication skills (verbal and written), time management, organization, multi‑tasking, professional interpersonal skills, telephony skills in a high‑call volume setting, proficient typing/keyboarding skills, analytical and problem‑solving skills. Ability to meet deadlines, work under pressure, handle sensitive information, maintain confidentiality, follow instructions, learn and apply knowledge, adapt to change, maintain professional relationships, 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, with quick and accurate typing/keyboarding skills. Six months experience in a Medicaid call center or high‑volume setting. Bilingual (English/Spanish) Language Skills Preferred Licensure, Certification, Or Registration Requirements N/A Contact Tiffany Trinidad – View phone number on click.appcast.io Background Screening All applicants must complete a State and National criminal history check and, if applicable, meet Chapter 435, F.S., and Chapter 408, F.S. requirements before beginning employment. Background screening includes fingerprinting for State and Federal criminal records checks through FDLE and FBI and may include local criminal history checks. Reasonable accommodation requests must be made in advance to allow sufficient time. The State of Florida supports a drug‑free workplace; all employees are subject to drug testing as required by law. Veterans’ Preference Eligible veterans receive preference in employment for Career Service vacancies. Candidates claiming Veterans’ Preference must attach supporting documentation (e.g., DD Form 214). Documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement. #J-18808-Ljbffr State of Florida