REGISTERED NURSE SPECIALIST - 64000648

State of Florida • Tallahassee, FL

2d • Onsite

About The Position

The role of a Clinical Eligibility Screener for the Florida Department of Health and Children's Medical Services is a vital one, providing top-notch support to individuals in need through the CMS Toll-Free Line. The primary purpose of this position is to ensure that all callers receive prompt, accurate, and courteous assistance with their inquiries and concerns. In this capacity, the screener will be responsible for processing referrals and physician attestations, as well as maintaining meticulous records of all interactions. This entails verifying the accuracy of information, updating databases, and ensuring compliance with relevant regulations and guidelines. By providing exceptional customer service, the screener helps to foster trust and confidence in the Florida Department of Health and Children's Medical Services, ultimately contributing to the well-being of the community. Effective communication and problem-solving skills are essential for success in this role, the screener must be able to navigate complex situations, address concerns, and provide clear, concise information to callers. Additionally, the ability to work in a fast-paced environment, prioritize tasks, and manage multiple responsibilities is crucial. By combining these skills with a patient-centered approach, the Clinical Eligibility Screener plays a critical role in delivering high-quality support to those in need, making a positive impact on the lives of individuals and families across Florida.

Requirements

• 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.
• Must have ability to read, comprehend, and communicate effectively verbally, using confident articulation, and proper tone, and in writing, to express facts clearly and concisely.
• Ability to establish and effective working relationships with others.
• Knowledge in medical terminology.
• Working knowledge of Microsoft Applications.
• Knowledge of computer software including applications.
• Thorough knowledge of modern office business equipment, practices, and procedures.
• Knowledge of organizational procedures, policies, practices, rules, and regulations.
• Great Interpersonal skills.
• Must be able to multi-task.
• Must be an active listener and ask question as appropriate.
• Active License as a Registered Nurse in the State of Florida in accordance with Florida Statute 464.
• Valid Driver’s license.

Nice To Haves

• 3 - 5 years clinical eligibility screening, and/or call center preferred.
• Pediatric nursing experience.
• Experience in caring for children with special healthcare needs or complex medical conditions.
• Experience with Microsoft Office applications.

Responsibilities

• Conducts phone-based screenings to determine clinical eligibility for services for enrolled or potentially enrolled children for the Managed Care Plan and Florida KidCare Title XXI subsidized plan.
• Evaluating patient health status, and interpreting special needs as reported by parents, caregivers, or physician attestation.
• Provides plan enrollment information to client and family.
• Documents in accordance with established guidelines while using the current electronic medical record program.
• Offer resources from state and local health agencies to support client families for plan enrollment.
• Attends meetings and conferences related to roles and responsibilities.
• Delivering high-quality support to clients and their families, ensuring they receive the necessary care and resources.
• Meets the continuing education requirements mandated by the Florida Board of Nursing.

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: Senior
• Education Level: High school or GED