Senior Medicaid Provider Enrollment Specialist

State-of-Florida; Clearwater (FL); On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Health insurance

Life insurance

Dental & vision

Retirement options

Paid holidays & leave

Job summary

The Agency for Health Care Administration (AHCA) is Florida’s leading health policy and planning entity, overseeing Medicaid providers and ensuring high-quality, cost-effective care. We seek a Senior Human Services Program Specialist to enhance provider enrollment processes and coordinate with multiple stakeholders across the Medicaid program.

You will conduct on-site reviews, validate re-enrollments, and verify documentation while collaborating with providers, SMMC plans, and headquarters

Qualifications

• Knowledge of Medicaid policies and procedures.
• Ability to use computer software and analyze data.
• Ability to work effectively under stress.
• Strong communication skills, both oral and written.
• Proficient problem-solving and decision-making.
• Ability to plan, organize, and coordinate assignments.
• Customer service orientation.
• Ability to build and maintain professional relationships.
• Ability to train providers and staff.
• Willingness to travel as needed.

Responsibilities

• Plan and conduct on-site New Provider Enrollment Reviews.
• Validate re-enrollment reviews to ensure Medicaid enrollment compliance.
• Verify licenses, tax receipts, and lease information.
• Research business status using state and public records.
• Submit findings and recommendations for action.
• Coordinate with providers, HQ staff, and plans to resolve enrollment issues.
• Represent the agency in partnerships and community groups as assigned.
• Perform other duties as assigned.
• Travel is required.
• This is not a remote position.

Skills

Medicaid knowledge

Data analysis

Customer service

Verbal & written communication

Problem solving

Planning & organizing

Team collaboration

Relationship building

Training providers

Travel readiness

Job description

The Agency for Health Care Administration (AHCA) is Florida’s leading health policy and planning entity, overseeing Medicaid providers and ensuring high-quality, cost-effective care. We seek a Senior Human Services Program Specialist to enhance provider enrollment processes and coordinate with multiple stakeholders across the Medicaid program.

You will conduct on-site reviews, validate re-enrollments, and verify documentation while collaborating with providers, SMMC plans, and headquarters