HUMAN SERVICES PROGRAM SPECIALIST - 64045155

Requisition No: 855418 

Agency: Department of Health

Working Title: HUMAN SERVICES PROGRAM SPECIALIST - 64045155

 Pay Plan: Career Service

Position Number: 64045155 

Salary:  $40,000 - $42,000 

Posting Closing Date: 06/24/2025 

Total Compensation Estimator Tool

Job posting category Internal Agency

Your Specific Responsibilities:

This position is a Regional Consultant for Ryan White Eligibility & ADAP for Area 3/13.

This is a Career Service position that works directly with new and existing clients eligible for Ryan White  Services and support across the 15 counties in Area 3/13.

This position:

Serves as the benefits specialis twithin the Area3/13 Ryan White Eligibility & AIDS Drug Assistance Program (ADAP), components of the Ryan White Part B Program by determining client eligibility,

Monitoring applications for accuracy, providing technical assistance, and trainings for health care providers and case managers as needed and assuring seamless dispensing of prescription services through contract pharmacy.

Assures client eligibility recommendations follow state regulations and HRSA guidelines and educates health care providers and case managers as changes occur. In collaboration with Ryan White Part B program staff, case managers, and field staff, ensures that clients are recertified for eligibility annually, reviews these certifications for accuracy and proper documentation; and ensures reporting of income Changes to the Federal Insurance Marketplace/IRS when appropriate.

Coordinates and oversees ADAP data collection and submits routine programmatic reports. Submits ADAP monthly reports.

Coordinates and collaborates with other benefit programs and agencies, including Medicare, Medicaid, and HRSA-funded agencies. Follows policies, and procedures in accordance with federal and state statutes And regulations, HRSA guidance, and departmental policies.

Reports data to supervisor on required quality indicators .Makes recommendations to the Programs Supervisor on quality improvement.Ensures pay of last resort and assesses the most cost-

effective strategies for ADAP by examining other benefit programs in which clients may be eligible. Contributes to Ryan White Part B and ADAP quality improvement initiatives on specific ADAP quality indicators, including recertification rates, client medication adherence and fill rates, and timeliness of eligibility approvals.

Ensures payment of insurance premiums and program implementation for Area3/13 ADAP Premium Plus program. Reviews applications for completeness and accuracy; advocating on behalf of clients with health insurance plan representatives, accountable care organizations, Medicaid, Medicare, the Centers for Medicare and Medicaid Services (CMS), and the Federal Insurance Marketplace; and disputes with health plans and other benefit programs. Processes disenrollment’s. 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, and conveys this information to case managers, field staff, and medical providers.

Complete EARS weekly. Attend and participate in staff meetings and training programs.

At all times maintains confidential information such as social security numbers, medical information and other confidential data in a secure manner. Respects the confidentiality of related issues by not discussing

With unauthorized staff. Per DOH Information Security and Privacy Policy & Confidential Information, staff have the authority to take confidential information into the field to perform job responsibilities. Staff must adhere to Field Policy for Confidential Information. Ensures discussions held between staff cannot be overheard by unauthorized staff. Reports suspected breaches of security to supervisor immediately.

Performs all other related duties as requested.

Working hours: (A) Daily from 8:00 am to 5:00 pm (B) Total hours in work week 40 (C) Explain any variation in work (split shift, rotation, etc.)

Required Knowledge, Skills, and Abilities:

Knowledge of Microsoft Systems

Strong Organization, Communication and Customer Service skills

Ability to handle confidential information.

Qualifications: