HUMAN SERVICES PROGRAM CONSULTANT I (PENDING RECLASSIFICATION)

State of Florida • Tallahassee, FL

3d • Onsite

About The Position

This position provides quality customer services on behalf of Florida Department of Health, Division of Children’s Medical Services (DCMS) with any needs that come through the DCMS Toll-Free Line. This position is responsible for processing referrals, redeterminations, and attestations, ensuring appropriate documentation of activities and quality assurance reviews. This is a professional position within the Clinical Eligibility Unit. This position is responsible for the eligibility determination by parent-based surveys or physician attestation of children eligible for the services of the State’s health plan for children and youth with special health care needs. This position performs eligibility activities in the specialized medical field of pediatrics. Conducts reviews for eligibility screening services for enrolled or potential enrolled children for the State’s health plan for children with special health care needs in collaboration with a registered nurse. This position provides quality customer services on behalf of DCMS by conducting eligibility screenings to determine current and/or continued eligibility for enrolled or potentially enrolled children for the State’s health plan for children and youth with special health care needs through the DCMS Clinical eligibility Unit Toll-Free Line-Free Line. Evaluates the health status of the patient through parent-based screening or attestation with the parent/guardian, includes taking appointments scheduled for eligibility screenings. Interprets the client’s special needs as reported by parent/caregiver. Escalate cases to a clinically licensed staff to handle complex cases. Documents in accordance with established guidelines while using the current electronic medical record program. Provides resources for other state and local health related agencies to maximize support to client parents/guardians. Attend meetings and conferences directly related to roles and responsibilities. Performs other related duties as assigned.

Requirements

• Valid Florida Driver’s license.
• Knowledge of organizational procedures, policies, practices, rules, and regulations.
• Ability to plan, organize and coordinate work assignments.
• Ability to meet deadlines and prioritize tasks effectively.
• Ability to communicate effectively verbally and in writing to express facts and ideas in a succinct and organized manner and make clear and convincing oral presentations.
• Ability to establish and maintain effective working relationships with others.
• Knowledge of medical terminology.
• Working knowledge of Microsoft Word, Excel, and other software.
• Thorough knowledge of modern office business equipment, practices and procedures.
• Great Interpersonal skills.
• Must be able to multi-task.
• Knowledge of computer software including applications.
• Must be an active listener and ask questions as appropriate.
• Learn and communicate effectively, orally and in writing, in English.

Nice To Haves

• 1-3 years eligibility screening, and/or call center preferred.
• Experience in a health program or programs for children with special healthcare needs.
• Experience with Client Relations Database System.

Responsibilities

• Responsible for the eligibility determination by parent-based surveys or physician attestation of children eligible for the services of the State’s health plan for children and youth with special health care needs.
• Performs eligibility activities in the specialized medical field of pediatrics.
• Conducts reviews for eligibility screening services for enrolled or potential enrolled children for the State’s health plan for children with special health care needs in collaboration with a registered nurse.
• Provides quality customer services on behalf of DCMS by conducting eligibility screenings to determine current and/or continued eligibility for enrolled or potentially enrolled children for the State’s health plan for children and youth with special health care needs through the DCMS Clinical eligibility Unit Toll-Free Line-Free Line.
• Evaluates the health status of the patient through parent-based screening or attestation with the parent/guardian, includes taking appointments scheduled for eligibility screenings.
• Interprets the client’s special needs as reported by parent/caregiver.
• Escalate cases to a clinically licensed staff to handle complex cases.
• Documents in accordance with established guidelines while using the current electronic medical record program.
• Provides resources for other state and local health related agencies to maximize support to client parents/guardians.
• Attend meetings and conferences directly related to roles and responsibilities.
• Performs other related duties as assigned.

Benefits

• Annual and Sick Leave benefits
• Nine paid holidays and one Personal Holiday each year
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options
• Retirement plan options, including employer contributions
• Flexible Spending Accounts
• Tuition waivers

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed