OPERATIONS & MGMT CONSULTANT MGR - SES - 64051634

Requisition No: 873946 

Agency: Department of Health

Working Title: OPERATIONS & MGMT CONSULTANT MGR - SES - 64051634

 Pay Plan: SES

Position Number: 64051634 

Salary:  $50,000 - $65,000 annually 

Posting Closing Date: 04/19/2026 

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This is an Internal Agency Opportunity

Applicants accepted only from current Department of Health employees (includes OPS, Career Service, SES and SMS employees). Applicants will not be accepted from outside of the department.

Your Specific Responsibilities:

This position spends the majority of the time engaged in supervisory responsibilities. This includes communicating with, motivating, training, and evaluating employees in addition to planning and directing employees’ work. The incumbent has the authority to hire, transfer, suspend, lay off, recall, promote, discharge, assign, reward, or discipline subordinate employees or effectively recommend such action. The incumbent will also be required to develop performance expectations, meet with staff regularly to discuss performance, complete performance reviews, maintain vacation and work schedules, ensuring proper coverage and complete timesheets.

The position performs a variety of complex support and supervisory functions which require substantial technical, financial, administrative and operational knowledge of accounting practices for the Florida Department of Health’s medical and dental programs. The duties of this full-time supervisory position will be dedicated to maximizing local accounts receivables through third party payers (Medicaid, Medicare, private insurance companies, organizations, etc.) for personal healthcare and dental services provided by qualified staff of the Florida Department of Health in Bay County (DOH Bay) as well as contracted County Health Departments within the DOH Bay Billing Hub. The incumbent in this position is a member of the DOH Bay Billing Hub and is responsible for supervising the provision of medical and dental billing to contracted County Health Departments that are members of the DOH Bay Billing Hub. The incumbent in this position is responsible for the integrity and confidentiality of data sets under his/her control.

Interacts with contracted members of the DOH Bay Billing Hub to develop processes and procedures used to support those counties in ensuring their medical and dental billing is performed in an accurate and timely manner. Works closely with staff to make sure contracted counties’ billing needs are met.

Supervises and plans the workload, deadlines, work objectives, and time utilization of the DOH Bay Billing Hub staff. Reviews, verifies, and approves employees’ Employee Activity Report records. Provides training of staff within the scope of a supervisor. Provides technical advice to staff on the establishment and maintenance of accounting procedures.

Processes all third-party reimbursement claims for personal healthcare and dental services provided by DOH Bay and contracted members of the DOH Bay Billing Hub.  Ensures all third-party payments are posted to the applicable clients’/organizations’ account within the Health Management System (HMS) and denied claims are to be researched and resubmitted within seven working days of the date of denial is received per DOH Accounts Receivable Policy, DOH 56-66-08. Solves billing problems by combining, evaluating and reasoning with information and data to reserve issues. Decision making and resolutions discussed and approved by immediate supervisor prior to implementation.

Coordinates and implements the credentialing process for DOH Bay as a group and for all healthcare and dental providers for third party payers (Medicaid, Medicare, and insurance companies who require or offer better reimbursement rates for providers who are credentialed) by gathering, maintaining and recording professional information and qualifications about the providers. Is the practice administrator for the DOH Bay information contained within the Council for Affordable Quality Healthcare (CAQH) website.

Develops and maintains current standards for submitting, receiving and following up of claims denied from third-party reimbursement sources. The standards will provide guidelines for medical and dental providers to ensure accuracy and validity of claims submitted for reimbursement. Responsible for evaluating and monitoring all third-party claims submitted by DOH Bay and contracted counties within the DOH Bay Billing Hub for reimbursement by the above referenced standard beginning monthly with corrective action plan for non-compliant claims.

Provides technical assistance to all staff providing medical and dental services involving third-party reimbursement from agencies and/or insurance companies. Provides training for all staff responsible for entering third-party insurance information into HMS and serves as the HMS Billing Administrator. Is the Account Administrator, uses, trains and provides support for staff required to use the following websites in order to perform functions of their positions:

Prepares statistical reports on a monthly basis: reports will include number of third-party reimbursement claims by vendor, amount filed, amount received, number and amount of denied claims by vendor, reasons for denial, number of denied claims resubmitted for payment, number or client write-off accounts, number of accounts sent to state collection agency. Prepares trend reports as described above, beginning July 1 of current fiscal year and concurrently thereafter. Assists internal clients with HMS billing reports, as needed. Analyzes statewide revenue reports to assist in determining appropriate action plans to increase revenue collected by DOH Bay.

Established and maintains relationships with various community organization representatives wishing to set up billing accounts with DOH Bay. Maintains up to date listings of all organizational billing accounts and provides updates to cashier(s). Submits monthly billing of all organizational accounts and follows up with organization representatives on any delinquent accounts.

Processes all client accounts for write-off and sent to collections routine in HMS on a monthly basis, following procedures outlined in the DOH Accounts Receivable Policy, DOH 56-66-08, completed for all contracted counties with the DOH Bay Billing Hub. Interacts and provides assistance to DOH Bay clients who have questions regarding accounts that have been written off or sent to a collection agent and takes appropriate action to resolve accounts.

Audits eligible services monthly to verify that all services eligible to be billed to Medicaid were billed correctly. Corrects and rebills any billing errors discovered and bills client service to Medicaid when clients are assigned to coverage retroactively. Ensures client monthly statements are printed and mailed to clients who have any outstanding balance owed to DOH Bay. Answers incoming calls from clients who have questions about their bill and/or want to make payment plan/arrangements.

Incumbent will serve as the DOH Bay Billing Hub Manager to include oversight of 11 staff who perform the billing functions for 11 County Health Departments: Bay, Jackson, Calhoun, Liberty, Dixie, Gilchrist, Levy, Santa Rose, Duval, Gulf, and Franklin.

Performs all other duties as assigned or as necessary.

Required Knowledge, Skills, and Abilities:

• Knowledge and experience with medical billing procedures.
• Knowledge and experience understanding medical terminology.
• Ability to review and input data with 100% accuracy.
• Ability to use and learn varied computer programs to include HMS, Availity, FLMMIS, and Microsoft Office.
• Ability to work independently with a sense of urgency to meet deadlines.
• Skills required: supervision, attention to details, time management, initiative, and problem solving.

Qualifications:

• At least three years of extensive medical or dental billing with the Florida Department of Health
• At least three years of experience using the DOH Health Management System (HMS).

Florida Department of Health Mission, Vision, and Values:

Mission:

To protect, promote & improve the health of all people in Florida through integrated state, county & community efforts.

Vision:

To be the Healthiest State in the Nation.

Values:

I nnovation: We search for creative solutions and manage resources wisely.

C ollaboration: We use teamwork to achieve common goals & solve problems.

A ccountability: We perform with integrity & respect.

R esponsiveness: We achieve our mission by serving our customers & engaging our partners.

E xcellence: We promote quality outcomes through learning & continuous performance improvement.

Where You Will Work:

Panama City, Florida

The Benefits of Working for the State of Florida:

Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including:

• Annual and Sick Leave benefits;
• Nine paid holidays and one Personal Holiday each year;
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options;
• Retirement plan options, including employer contributions (For more information, please click www.myfrs.com);

• Flexible Spending Accounts;
• Tuition waivers;
• And more!

For a more complete list of benefits, including monthly costs, visit www.mybenefits.myflorida.com.

Please be advised:

Your responses to qualifying questions for this position must be verifiable by documentation provided through the electronic application process.  

This position requires a security background check and/or drug screening and participation in direct deposit. Any misrepresentations or omissions will disqualify you from employment consideration. Note: You will be required to provide your Social Security Number (SSN) in order to conduct this background check Successful completion of a drug test is a condition of employment for safety-sensitive positions.

Male applicants born on or after October 1, 1962, will not be eligible for hire or promotion unless they are registered with the Selective Services System (SSS) before their 26th birthday, or have a Letter of Registration Exemption from the SSS. For more information, please visit the SSS website: http://www.sss.gov 

If you are a retiree of the Florida Retirement System (FRS), please check with the FRS on how your current benefits will be affected if you are re-employed with the State of Florida.  Your current retirement benefits may be canceled, suspended or deemed ineligible depending upon the date of your retirement. 

The successful candidate will be required to complete the Form I-9 and that information will be verified using the E-Verify system.  E-Verify is operated by the Department of Homeland Security in partnership with the Social Security Administration to verify employment eligibility.   

Incumbents may be required to perform emergency duty before, during, and/or beyond normal work hours or days.

All Florida Department of Health positions require the incumbent to be able to learn and communicate effectively, orally and in writing, in English. Applicants who do not meet this requirement will not be considered.  

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer and does not tolerate discrimination or violence in the workplace. 

Applicants requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-877-562-7287). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation. 

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act. 

Florida has the third largest population of veterans in the nation with more than 1.5 million service men and women.  The Florida Department of Health (department) is committed to serving members of the United States Armed Forces, veterans and their families by encouraging them to apply for vacancies that fit their area of knowledge and/or expertise.  Through the Department's VALOR program, which expedites licensing for military veterans, the Department also waives initial licensing and application fees for military veterans who apply for a health care professional license within 60 months of an honorable discharge. These initiatives help ensure that the transition from military service into the workforce is as smooth as possible and reflects our appreciation for the dedication devoted to protecting our country.    

Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and/or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.