Florida Staffing
Human Services Program Analyst
This position is a Ryan White Eligibility and ADAP Specialist for FDOH Alachua. This is a Career Service position that works directly with new and existing eligible clients for Ryan White Services and support in Alachua County. This position: Performs eligibility services for the Florida Ryan White and AIDS Drug Assistance Program (ADAP). This is a highly sensitive position where easy access to HIV/AIDS services are essential, and information security is maintained following the need-to-know information security guidelines. Enrolls newly diagnosed and currently active HIV + clients in DOH Area 3, completing an annual enrollment for Ryan White Services and ADAP. Complete financial eligibility consistent with Florida HIV/AIDS Eligibility Procedure Guidelines and Ryan White Patient Care program guidelines. Documents financial eligibilities in the FL Ryan White Patient Care Eligibility Portal, CareWare software systems, as well as HMS. Document ADAP in Provide Enterprise (PE) software systems and HMS. Verification of insurance, income, residency in accordance with DOH policy and Ryan White Eligibility manual is required. Conduct ADAP eligibility in accordance with ADAP eligibility manual and ensure appropriate documentation is uploaded in Provide software system. Upload most recent prescriptions, labs, insurance and other information as applicable in Provide software system as changes occur. Interviews pregnant women to determine eligibility for presumptive Medicaid benefits using manual procedures and a computerized Florida System. Assess clients for psycho-social needs such as Food stamps, housing, transportation, legal, mental health and substance abuse and refer as appropriate. Establishes liaisons with economic services staff to facilitate referrals, track dispositions, and assist clients in complying with the Medicaid application process. Serve as back up for Area 3 Staff and travel throughout Area 3/13 as needed. Ensures eligibility and clinical data is entered timely and accurately following program guidelines. Enters viral loads and CD4 counts every 4-6 months into PE module to ensure viral suppression. Participates in ADAP monthly telephone conference calls. Maintain knowledge of Medicare Part C & D programs, Affordable Care Act and private insurance programs. Maintain an understanding of adequate coverage based on ADAP standards, insurance terminology as well as an understanding of HIV medication and labs. Ensures payment for insurance premiums and program implementation for Alachua County clients enrolled in ADAP Premium Plus program. Reviews applications for completeness and accuracy; advocating on behalf of clients with health insurance plan representatives, accountable care organizations, Medicare, Medicaid, The Centers for Medicare and Medicaid Services (CMS), and the Federal Insurance Marketplace; and disputes with health plans and other benefit programs. Processes disenrollments. Maintains expertise and knowledge in other benefit programs, including Medicare, Medicaid, SSI, SSDI, the state's health insurance premium payment program, and other federal and state categorical assistance programs. Conveys information to case managers, field staff and medical providers. Collaborate with community-based organizations and pharmacy personnel to ensure continuity of care. Complete EARS Weekly; attend and participate in staff meetings and trainings. Performs all other related duties as requested. Required Knowledge, Skills, and Abilities: Knowledge of Microsoft Systems Experience working in Electronic Medical Records Strong Organization, Communication and Customer Service skills Qualifications: Minimum - Must have valid driver's license and access to reliable transportation. Experience working in Electronic Medical Records. Strong communication and customer service skills. Ability to handle confidential information. Preferred experience working with community based organizations Where You Will Work: DOH-Alachua 224 SE 24th Street Gainesville FL 32641
This position is a Ryan White Eligibility and ADAP Specialist for FDOH Alachua. This is a Career Service position that works directly with new and existing eligible clients for Ryan White Services and support in Alachua County. This position: Performs eligibility services for the Florida Ryan White and AIDS Drug Assistance Program (ADAP). This is a highly sensitive position where easy access to HIV/AIDS services are essential, and information security is maintained following the need-to-know information security guidelines. Enrolls newly diagnosed and currently active HIV + clients in DOH Area 3, completing an annual enrollment for Ryan White Services and ADAP. Complete financial eligibility consistent with Florida HIV/AIDS Eligibility Procedure Guidelines and Ryan White Patient Care program guidelines. Documents financial eligibilities in the FL Ryan White Patient Care Eligibility Portal, CareWare software systems, as well as HMS. Document ADAP in Provide Enterprise (PE) software systems and HMS. Verification of insurance, income, residency in accordance with DOH policy and Ryan White Eligibility manual is required. Conduct ADAP eligibility in accordance with ADAP eligibility manual and ensure appropriate documentation is uploaded in Provide software system. Upload most recent prescriptions, labs, insurance and other information as applicable in Provide software system as changes occur. Interviews pregnant women to determine eligibility for presumptive Medicaid benefits using manual procedures and a computerized Florida System. Assess clients for psycho-social needs such as Food stamps, housing, transportation, legal, mental health and substance abuse and refer as appropriate. Establishes liaisons with economic services staff to facilitate referrals, track dispositions, and assist clients in complying with the Medicaid application process. Serve as back up for Area 3 Staff and travel throughout Area 3/13 as needed. Ensures eligibility and clinical data is entered timely and accurately following program guidelines. Enters viral loads and CD4 counts every 4-6 months into PE module to ensure viral suppression. Participates in ADAP monthly telephone conference calls. Maintain knowledge of Medicare Part C & D programs, Affordable Care Act and private insurance programs. Maintain an understanding of adequate coverage based on ADAP standards, insurance terminology as well as an understanding of HIV medication and labs. Ensures payment for insurance premiums and program implementation for Alachua County clients enrolled in ADAP Premium Plus program. Reviews applications for completeness and accuracy; advocating on behalf of clients with health insurance plan representatives, accountable care organizations, Medicare, Medicaid, The Centers for Medicare and Medicaid Services (CMS), and the Federal Insurance Marketplace; and disputes with health plans and other benefit programs. Processes disenrollments. Maintains expertise and knowledge in other benefit programs, including Medicare, Medicaid, SSI, SSDI, the state's health insurance premium payment program, and other federal and state categorical assistance programs. Conveys information to case managers, field staff and medical providers. Collaborate with community-based organizations and pharmacy personnel to ensure continuity of care. Complete EARS Weekly; attend and participate in staff meetings and trainings. Performs all other related duties as requested. Required Knowledge, Skills, and Abilities: Knowledge of Microsoft Systems Experience working in Electronic Medical Records Strong Organization, Communication and Customer Service skills Qualifications: Minimum - Must have valid driver's license and access to reliable transportation. Experience working in Electronic Medical Records. Strong communication and customer service skills. Ability to handle confidential information. Preferred experience working with community based organizations Where You Will Work: DOH-Alachua 224 SE 24th Street Gainesville FL 32641