Program Specialist

Help connect Texans living with HIV to critical medication and insurance assistance. As a Program Specialist , you will review applications, verify eligibility information, enter data, answer questions, and support applicants and community partners throughout the enrollment process. This role is ideal for someone with health insurance knowledge, strong customer service skills, and excellent attention to detail.

Who You’ll Work With

• Join a state public health program that helps eligible Texans access medications, insurance assistance, and related services.
• Collaborate with applicants, community enrollment workers, regional coordinators, and internal program staff.
• Work under moderate supervision while following established eligibility guidelines and confidentiality requirements.

Major Duties

• Review new, recertification, and self-attestation applications for medication and insurance-assistance programs.
• Verify documentation related to HIV status, financial eligibility, Texas residency, insurance coverage, and other program requirements.
• Enter and update demographic, eligibility, and verification information in program databases.
• Help clients identify appropriate insurance coverage during ACA Marketplace Open Enrollment.
• Answer questions from applicants and community enrollment workers about program requirements and application procedures.
• Identify incomplete applications and communicate what additional documentation is needed.
• Prepare initial denial determinations for applicants who may not meet eligibility requirements and refer final decisions, exceptions, and appeals for secondary review.
• Support outreach, workshops, and training related to eligibility and enrollment procedures.
• Assist with updating applications, forms, instructions, guidelines, and screening processes.
• Compile productivity statistics and other data for reports, projections, and quality-improvement activities.
• Support program planning, evaluation, research, and special projects.
• Participate in disaster-response or Continuity of Operations activities when required.

What We’re Looking For

• High school diploma or equivalent.
• Health insurance experience and strong customer service skills.
• Knowledge of health insurance and the ACA Marketplace.
• Familiarity with public health programs, confidentiality requirements, and eligibility processes.
• Clear written and verbal communication skills.
• Strong data-entry skills with a focus on speed and accuracy.
• Ability to review detailed documentation and apply established eligibility criteria.
• Professional interpersonal, collaboration, training, negotiation, and de-escalation skills.
• Ability to prepare accurate reports and correspondence.
• Proficiency with Microsoft Excel and Word.
• Ability to protect confidential client information.
• Ability to manage multiple deadlines and time-sensitive assignments with minimal supervision.
• Ability to learn systems such as Genesys, TakeChargeTexas, Ramsell, Availity, and HMS.

Preferred Knowledge

• HIV/AIDS-related public health, social, and economic issues.
• Medical terminology and medications commonly used to treat HIV/AIDS and sexually transmitted infections.
• Public health laws, regulations, and payer-of-last-resort requirements.
• Experience training others or working with community-based enrollment partners.

Exciting Opportunity Details

• Schedule: Monday–Friday, 8:00 a.m.–5:00 p.m. during training, Tuesday–Saturday, 9:00 a.m.–6:00 p.m for the rest of the contract.
• Hours: 40 hours per week.
• Possible overtime during ACA Marketplace Open Enrollment.
• Alternate schedules or work locations may be required during disaster-response or Continuity of Operations activities.
• Pay rate: $34/hr

The Peak Performers Difference

• Comprehensive medical, dental, and vision insurance coverage is available beginning the first day of the month following 60 days of employment.
• Employees may participate in a 403(b) retirement plan.
• Qualified applicants with chronic medical conditions and/or disabilities receive priority placement.
• Weekly pay through direct deposit.
• In business since 1994 with thousands of successful job placements.

All employment offers are contingent upon the successful completion of a pre-employment criminal background check in compliance with applicable federal, state, and local laws.

Applicants for employment with Peak Performers must possess work authorization that does not require visa sponsorship now or in the future.

Peak Performers is an equal opportunity employer and considers all applicants without regard to race, marital status, sex, age, color, religion, national origin, veteran status, disability, or any other characteristic protected by law. Peak Performers does not accept unsolicited resumes from headhunters, recruitment agencies, or fee-based recruitment services.

Custom Job ID: 27-TX-RC3089