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Posted: 10/10/2026Senior Human Services Program Specialist
State of FloridaPosted 10/19/2026full-timeFort Myers • Florida • United StatesSenior💰 $42,561 - $55,330 per yearWebsite
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medicaid program regulations and fair hearing processes while effectively communicating and collaborating with stakeholders. Proficient in data organization, complaint resolution, and customer service within a fast-paced environment.
Highest-signal resume keywords
Medicaid Program KnowledgeComplaint ResolutionEffective CommunicationData OrganizationCustomer Service Experience
About the role
Key responsibilities & impact- Maintain up-to-date knowledge about the Florida Medicaid program through Agency training, self-education, websites, provider alerts, and MRS SharePoint sites
- Search for pertinent federal laws and regulations, applicable state statutes, and Medicaid rules
- Remain informed about Agency projects, initiatives, Statewide Medicaid Managed Care contract provisions, amendments, talking points, guidance statements, subcontractors, TPAs, and all-plan communications
- Assess newly assigned fair hearing requests and verify issues were correctly entered into the complaint module
- Correct errors, alert the supervisor for staff training purposes, and search for duplicate active complaint submissions
- Request legal sufficiency documents from SMMC plans or FFS vendors for submission to the Office of Fair Hearing
- Confirm disputed services remain in place pending hearing outcomes when appropriate
- Assign an Agency fair hearing liaison and request respondent evidence
- Process and share related documents with the Office of Fair Hearing according to protocols
- Monitor active fair hearings and ensure timely complaint module updates
- Review MedicaidHearingUnit box assignments and triage and process messages and related documents promptly
- Research and respond to Legislative Assignments, CorrFlow, and other priority fair-hearing issues
- Contact constituents for information and provide updates while maintaining communication throughout resolution
- Represent the Agency at government and community partnerships, outreach events, Secret Shopper assignments, Medicaid presentations, transportation boards, community alliances, interagency agreement teams, local planning groups, HIV planning councils, and social services agency forums
- Perform other duties as assigned
Requirements
What you’ll need- Two years of experience providing a professional level of customer service in a fast-paced consumer-centric environment
- Ability to communicate effectively, verbally and in writing
- Ability to determine work priorities, assign work and ensure proper completion of work assignments within established timeframes
- Ability to establish and maintain effective working relationships with others
- Ability to investigate, analyze, and resolve complaints
- Ability to organize data into a logical format for presentations, reports, and other written materials
- Ability to provide training to providers, coworkers, and community agencies
- Ability to review and evaluate plans and programs
- Ability to solve problems and make decisions in a timely manner
- Ability to understand and apply applicable rules, regulations, policies, and procedures
- Ability to use databases
- Ability to utilize Microsoft Office Suite
- Ability to work independently
- Ability to travel with or without accommodation
- Moderate to extensive experience and abilities using different computer programs such as Excel, Outlook, and Word, etc., including quick and accurate typing/keyboarding skills (preferred)
- Must successfully complete a State and National criminal history check as a condition of employment
- Subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act
Benefits
Comp & perks- 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
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Complaint Module ManagementLegal Document ProcessingData AnalysisReport WritingDatabase Utilization
Soft Skills
Problem SolvingDecision MakingRelationship BuildingTraining AbilityTime Management
Tools & Technologies
Microsoft Office SuiteExcelOutlookWordMRS SharePoint
Certifications & Qualifications
State and National Criminal History Check
Industry Keywords
Florida Medicaid ProgramFair Hearing ProcessStatewide Medicaid Managed CareConsumer-Centric EnvironmentDrug-Free Workplace Act