SENIOR ELIGIBILITY SPECIALIST III (COE) - 60065952

State of Florida•Fort Myers, FL

6d•Remote

About The Position

This role was formerly the Eligibility Specialist II position with the Specialized Medicaid Center of Excellence within the Office of Economic Self Sufficiency. The position has been upgraded to a Senior Eligibility Specialist III (COE) and may be assigned to a Long-Term Care (ICP) processing or inquiry unit, Disability Determination (DDD) unit, or Department Hearings Representatives unit. This is an Internal Agency Opportunity and only qualified candidates currently employed with the Department of Children and Families will be considered. This position may be located anywhere in the State of Florida. Location: Any county in the State of Florida. This position is eligible for teleworking. The salary for this position is $43,822.74. This is a professional position in the Economic Self Sufficiency Program for the statewide Specialized Medicaid Center of Excellence (SMCOE). The primary responsibility is to determine eligibility for various public assistance programs. This involves tasks such as reviewing cases throughout the different stages of the service delivery model, conducting thorough case reviews to ensure compliance with program requirements, and providing training or mentoring for staff to strengthen accuracy rates.

Requirements

Knowledge of principles and processes for delivering exceptional customer and personal services, including needs assessment, quality standards, alternative delivery systems, and customer satisfaction evaluation techniques.
Apply the laws, rules, and regulations governing eligibility and grant determination for multiple government assistance programs and the case administration of these programs.
Develop comprehensive plans and implementation procedures.
Familiarity with methods for compiling, organizing, and analyzing data.
Read, understand, apply complicated and detailed regulations, and policy directives.
Strong social perceptiveness to recognize and understand others' reactions and underlying motivations.
Knowledge of problem-solving techniques.
Knowledge of training principles and practices.
Knowledge of goal setting techniques.
Ability to perform complex arithmetic operations.
Ability to conduct thorough fact-finding interviews and accurately prepare and maintain detailed records and reports.
Ability to establish and maintain effective working relationships with a diverse range of individuals.
Ability to investigate and effectively respond to customers and providers complaints.
Ability to compose documents involving technical information.
Ability to prioritize and meet deadlines.
Ability to communicate effectively both orally and in writing.
Ability to apply ethical business practices.
Two years or more of Paraprofessional experience in a position where the major responsibility was determining eligibility, conducting interviews, providing counseling, recruiting, billing or collecting accounts, checking credit, processing insurance policies or claims or providing customer service.
OR An Associate's degree, or higher from an accredited college or university can substitute for the experience.
OR 60 semester or 90 quarter hours can substitute for the experience.
Minimum of two years case processing experience in the State of Florida Department of Children & Families as an Eligibility Specialist I, with at least one year of eligibility processing experience in specialized Medicaid programs, specifically Long Term Care/Institutional Care programs, Hospice, Waivers or Disability Determination programs.

Nice To Haves

Prior experience in a position where the major responsibility was working with legal and/or medical paperwork.

Responsibilities

Reviewing and analyzing data from quality control and monitoring sources to identify trends, address issues, and provide targeted training to improve staff accuracy and performance.
Provides training and mentoring to staff to improve accuracy rates and overall performance. Conducts mentoring sessions and delivers targeted training in areas where quality issues are identified, supporting continuous improvement and professional development.
Performing quality management system reviews, identifying case reading errors, and ensuring timely and accurate corrections to maintain compliance with program standards.
Planning, evaluating, leading and guiding staff towards continuous quality improvement.
Participating in the preparation and completion of Ad Hoc reports, ensuring accuracy and timeliness in meeting regional and departmental needs.
Interacts with applicants, recipients, and other stakeholders, providing excellent customer service. Addresses and resolves inquiries and complaints promptly and professionally.
Representing the Department in hearings, preparing case documentation completes supervisory reviews, and corrects cases.
Provides guidance to internal and external stakeholders, explaining processes, addressing questions, and resolving issues efficiently. Maintains professionalism and a customer-oriented approach while navigating complex situations.
Instructing applicants and providers in completion of various forms, and reviewing the applications and forms submitted for completeness and accuracy.
Research case information thoroughly to develop recommendations and alternative solutions. Utilizes problem solving and critical thinking by combining, evaluating, and reasoning with information and data to make decisions and solve problems.
Advising applicants and providers of deadlines, time frames, and necessary actions to be taken.
Participates in special work assignments and other related duties as required or assigned.