Program Specialist

• Plan and conduct on-site New Provider Enrollment Reviews
• Validate re-enrollment reviews of current Medicaid providers
• Determine whether providers meet Medicaid provider enrollment requirements
• Verify professional licenses, business tax receipts, lease information, and other documentation
• Research internet sources to determine or verify business status and ownership
• Submit findings and recommendations to Medicaid Provider Enrollment for further action
• Coordinate with Medicaid providers, Headquarters staff, and SMMC plans to research and resolve assigned enrollment and site-visit issues
• Document activities in the complaint module according to current protocols
• Represent the Agency in government and community partnerships, Medicaid overview presentations, secret shopper events, transportation boards, community alliances, interagency agreement teams, local planning groups, and HIV planning councils
• Perform other duties as assigned
• Travel 25–50%

Senior Human Services Program Specialist

• Provide full-time customer service in a high-volume Contact Center
• Answer recipient and provider questions regarding Medicaid covered services
• Provide Choice Counseling regarding Statewide Medicaid Managed Care programs
• Make referrals to appropriate agencies
• Work in the Bureau of Medicaid Recipient Services
• Enhance delivery of health care services through the Florida Medicaid Program
• Work in a fast-paced, team-based environment