OPS Registered NURSE Specialist - 64800947

Ops Registered Nurse Specialist

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.

Your Specific 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.

Required Knowledge, Skills, and Abilities:

• 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 maintain 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.
• Great Interpersonal skills.
• Must be able to multi-task.
• Must be an active listener and ask question as appropriate.

Qualifications:

• Minimum: Active License as a Registered Nurse in the State of Florida in accordance with Florida Statute 464.
• Valid driver license.
• Preferred: Years of Experience: 3 - 5 years clinical eligibility screening, and/or call center.
• Pediatric nursing experience.

Where You Will Work: 2020 Capital Circle SE, Tallahassee, FL 32399 with 10% travel.

The Benefits of Working for the State of Florida:

• State of Florida 401(a) FICA Alternative Plan (mandatory)
• Participation in state group insurance (upon meeting eligibility requirements. Consult with People First and/or the serving HR office)
• Workers' Compensation (mandatory, if needed)
• Reemployment Assistance (Unemployment Compensation) (mandatory, if needed)
• Deferred Compensation (voluntary)
• Employee Assistance Program (voluntary)
• And more! For a more complete list of benefits, including monthly costs, visit www.mybenefits.myflorida.com.