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68000159 - OPERATIONS & MGMT CONSULTANT MGR - SES

Date: Jun 9, 2021

Location: TALLAHASSEE, FL, US, 32308

The State Personnel System is an E-Verify employer. For more information click on our E-Verify website.

Requisition No: 394203 

Agency: Agency for Health Care Administration

Working Title: 68000159 - OPERATIONS & MGMT CONSULTANT MGR - SES

Position Number: 68000159 

Salary:  $1673.36 - $1,757.03 / Bi-Weekly Depending on Experience 

Posting Closing Date: 06/23/2021 

This is an exciting opportunity to help shape the quality of health care in Florida. The Agency for Health Care Administration (AHCA) is the State of Florida agency responsible for oversight of the Medicaid program.  The Medicaid program provides low-income families and individuals with access to health care.  If you have a desire to use your talent and skills at an organization that provides critical services to millions of individuals and families across the state, AHCA invites you to apply to become an essential member of our team. As one of Florida’s leading state agencies, AHCA’s diverse workforce community of more than 1,400 employees is proud of its efforts to serve the people of Florida.

 

We are seeking to hire an Operations & Management Consultant Manager-SES who desires to work to enhance the delivery of health care services through the Florida Medicaid Program.  This position requires a candidate who is creative, flexible, innovative, and who will thrive in a fast-paced, team based work environment.

 

This position is located in the Medicaid Third Party Liability Unit (TPL).  Federal and State laws require Florida Medicaid to be responsible for identifying, managing and recovering funds for claims paid for by Florida Medicaid for which a third party was liable, thereby ensuring Medicaid is the payer of last resort.  Some examples of liable third parties include Medicare and other insurance companies, casualty settlements, recipient estates, and trust and annuity recovery. Medicaid TPL serves as the primary organizational unit within the Agency to provide oversight and monitoring of the Agency’s third-party liability vendor contract. 

 

This position is responsible for monitoring the performance of the Medicaid Third Party Liability (TPL) Contractor. This position is responsible for the design and operation of performance reviews specific to the Casualty, Estate, and Trust/Annuity Recovery Program to ensure contractor effectiveness and compliance with contractual agreements.  This position develops and reviews procurement documents and operating procedures for the TPL contractor.  The incumbent will correspond with contractor staff, attorneys, and stakeholders on a daily basis. The incumbent will review case-specific requests for recovery reductions and makes recommendations to the AHC Administrator. The incumbent will review unique case situations and advises TPL contractor on how to proceed. This position reviews contractor invoices, reports, and refund requests for accuracy. The incumbent will serve as backup for functions of other staff. This position is responsible for the management of the Operations Review Specialist and OPS Administrative Secretary Positions in the TPL unit.  The incumbent will perform other related duties as required or assigned.

 

Contract management/ monitoring experience and experience in subrogation or third-party recoveries is preferred. 

Experience working with Microsoft Office software products (i.e. Word, Excel. Access, etc.) is required.

 

AHCA offers an excellent array of benefits, including:                     

  • Health insurance
  • Life insurance
  • Dental, vision and supplemental insurance      
  • Retirement benefits         
  • Vacation and sick leave
  • Paid holidays
  • Opportunities for career advancement
  • Tuition waiver for public college courses
  • Training opportunities

 

KNOWLEDGE. SKILLS. AND ABILITIES

  • Knowledge of basic management principles and practices.
  • Knowledge of the methods of data collection and analysis.
  • Ability to supervise people.
  • Ability to manage a program designed to ensure the resolution of managerial and operational problems. Ability to determine work priorities, assign work and ensure proper completion of work.
  • Ability to communicate effectively both verbally and in writing.
  • Ability to establish and maintain effective working relationships with others both internally and externally. Ability to formulate polies and procedures.
  • Ability to understand and apply applicable rules, regulations, policies and procedures relating to operational and management analysis activities.
  • Ability to organize data into logical format for presentations in reports, documents, and other materials.
  • Ability to collect, evaluate, and analysis data to develop alternative recommendations, solve problems, document work and other activities relating to the improvement of operation and management practices.
  • Ability to conduct fact-finding research.
  • Ability to work independently.
  • Ability to solve problems and make decisions.

 

MINIMUM QUALIFICATION REQUIREMENTS

Experience working with Microsoft Office software products (i.e. Word, Excel. Access, Outlook etc.) is required.

Bachelor’s degree from an accredited college or university is highly preferred.

Valid Drivers License

 

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

 

CONTACT:  DAN GABRIC 850-412-4137

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

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.


Nearest Major Market: Tallahassee