SENIOR HUMAN SERVICES PROG ANALYST - 64004299

State of Florida • Orlando, FL

1d • Onsite

About The Position

The Senior Human Services Program Specialist works with a high volume of clients seeking patient care services through the Ryan White HIV/AIDS Program (RWHAP) AIDS Drug Assistance Program (ADAP) Unit at the Sunshine Care Center. The role interviews clients and evaluates their eligibility for ADAP Direct Dispense or ADAP Premium Plus programs. It maintains required client documentation in state and program data systems, including the Health Management System (HMS), ADAP Provide Enterprise (PE), and the RWHAP Part B Portal. The specialist collaborates with case managers, peer navigators, outreach staff, nurses, medical providers, and other partners as part of a patient-centered care team.

The role maintains a caseload of at least 250 clients, supports ADAP enrollment and re-enrollment, and helps clients address insurance coverage, copayments, deductibles, Medicare coverage, and other program requirements. It also tracks medication pickup, eligibility expiration, and laboratory information; analyzes program data; and works to meet statewide targets for medication pickup, laboratory monitoring, and eligibility enrollment. Other related duties may be assigned.

The position is based at the Sunshine Care Center, 832 West Central Boulevard, Orlando, Florida. The employee must be able to work in the office daily and may be required to perform emergency duties before, during, or beyond normal work hours or days, including possible in-state or out-of-state deployment.

Requirements

• One year of verifiable experience entering data using an electronic medical record system.
• One year of verifiable experience interviewing or counseling clients.
• One year of verifiable customer service experience.
• Basic computer skills.
• Ability to read laboratory reports and prescriptions, and familiarity with medical terminology.
• Professional communication skills for communicating with providers and the public.
• Knowledge of funding sources for HIV medication.
• Knowledge of insurance terminology.
• Ability to analyze documentation and document findings.
• Ability to communicate with case managers, medical and pharmaceutical contacts, and BRHPC.
• Ability to ensure the Ryan White HIV/AIDS Program is the payor of last resort.
• Knowledge of community resources and agencies.
• Ability to identify client needs and coordinate services.
• Must not have been debarred, suspended, or excluded from federal assistance programs.
• Must be authorized to work in the United States without employer sponsorship.
• Must be willing and able to come to the office daily to perform the duties and responsibilities.
• Must be willing to work before, during, and/or beyond normal work hours or days in an emergency, potentially including in-state or out-of-state deployment.
• Must learn and communicate effectively in English, orally and in writing.
• Must complete the required security background check and/or drug screening and participate in direct deposit.
• Successful completion of a drug test is a condition of employment for safety-sensitive positions.

Responsibilities

• Determine client eligibility for ADAP Direct Dispense or ADAP Premium Plus.
• Maintain and manage the RWHAP Part B Portal to ensure client documentation is up to date.
• Maintain a caseload of at least 250 clients.
• Interview clients, review records, and confer with medical providers and case managers to evaluate client adherence.
• Counsel clients individually to address deficiencies related to transitioning to ACA health insurance coverage, copayments, deductibles, and related life changes.
• Educate clients about Medicare Parts C and D, including copayments and deductibles.
• Complete ADAP enrollment and re-enrollment.
• Collect insurance and supporting documentation as required by program rules.
• Document progress notes in databases according to program requirements.
• Collaborate with case managers, physicians, and pharmacies to ensure program requirements are met.
• Communicate with health insurance companies about clients’ copayments, deductibles, and medication coverage.
• Contact Direct Dispense and retail clients regarding medication pickup.
• Contact clients regarding expiring or expired ADAP eligibility.
• Update client laboratory information in the Provide database every six months.
• Analyze data to measure program effectiveness and support statewide targets for medication pickup, laboratory monitoring, and eligibility enrollment.
• Perform other related duties as assigned.
• Perform emergency duties before, during, or beyond normal work hours or days when required; emergency deployment may be in-state or out-of-state.

Benefits

• Annual and sick leave
• Nine paid holidays and one personal holiday each year
• State group insurance options, including health, life, dental, vision, and supplemental insurance
• Retirement plan options, including employer contributions
• Flexible spending accounts
• Tuition waivers

What This Job Offers

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