Senior Human Services Program Specialist

Jobtailor; Jacksonville (FL); On-site; USD 42,000 - 54,000; Full time

Job summary

Jobtailor seeks a proactive professional to handle Medicaid-related inquiries and complaints. You will research policy, coordinate with stakeholders, and provide technical assistance to help recipients and providers understand coverage requirements in a fast-paced, team-based setting.

The role emphasizes strong communication, data entry accuracy, and collaboration with policy staff and care plans to resolve issues effectively.

Qualifications

• Two years of experience providing a professional level of customer service in a fast-paced consumer centric environment.
• Proficient in using different computer programs such as Excel, Outlook, and Word, with quick and accurate typing skills.

Responsibilities

• Research and respond to Medicaid issues, concerns, and complaints.
• Provide technical assistance to help recipients and providers understand Medicaid coverage policy.
• Coordinate with recipients, providers, policy staff, plan management staff, and SMMC plans to resolve Medicaid managed care issues.
• Receive, research, and respond to special assignments on behalf of Medicaid recipients and providers.
• Contact constituents to obtain information and refer issues as needed.
• Complete assessments of newly assigned issues to confirm proper entry in the complaint module.
• Represent the Agency in government/community partnerships and outreach events.
• Perform other duties as assigned.

Skills

Creativity

Team Collaboration

Customer Service

Research & Problem-Solving

Tools

Excel

Outlook

Word

Job description

• 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 responsible for researching and responding to Medicaid issues, concerns, and complaints, as well as providing technical assistance to help recipients and providers understand Medicaid coverage policy and assure that recipients receive proper care as set forth in State Statutes, rules, policies, and Code of Federal Regulations.
• Coordinates with Medicaid recipients, providers, policy staff, plan management staff, and Statewide Medicaid Managed Care (SMMC) plans as needed to research and resolve assigned Medicaid managed care issues.
• Receives, researches, and responds to special assignments regarding questions and priority issues on behalf of Medicaid recipients and providers.
• Contacts constituent to obtain information. Researches, resolves, and responds to issues, making appropriate referrals as needed.
• Completes assessments of newly assigned issues in the complaint module to confirm issues were entered correctly.
• Represents the Agency on government and community partnerships, community outreach events, and Secret Shopper assignments.
• Performs other duties as assigned.

Requirements

• Two years of experience providing a professional level of customer service in a fast-paced consumer centric environment.
• Moderate to extensive experience and abilities using different computer programs such as Excel, Outlook, and Word, etc., including quick and accurate typing/keyboarding skills.

Core Competencies

Demonstrates expertise in Medicaid policy and customer service, with strong abilities in research, problem-solving, and effective communication. Proficient in utilizing various computer programs to support Medicaid recipients and providers in a fast-paced environment.

Highest-signal resume keywords

• Medicaid Policy Knowledge
• Customer Service Experience
• Research and Problem-Solving
• Technical Assistance
• Computer Proficiency

ATS Optimization Keywords

Soft Skills

• Creativity
• Flexibility
• Innovation
• Team Collaboration

Industry Keywords

• Medicaid
• State Statutes
• Code of Federal Regulations
• Managed Care
• Community Outreach

Tools & Technologies

• Excel
• Outlook
• Word