68048485 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST

State of Florida•South Highpoint, FL

21h•Onsite

About The Position

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. This position is not a remote or telework position.

Requirements

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
Two years of experience providing a professional level of customer service in a fast-paced consumer centric environment.

Nice To Haves

Moderate to extensive experience and abilities using different computer programs such as Excel, Outlook, and Word, etc., including quick and accurate typing/keyboarding skills.

Responsibilities

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

Benefits

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