68019357 - AGENCY FOR HEALTH CARE ADMINISTRATOR-SES

Requisition No: 857900 

Agency: Agency for Health Care Administration

Working Title: 68019357 - AGENCY FOR HEALTH CARE ADMINISTRATOR-SES

 Pay Plan: SES

Position Number: 68019357 

Salary:  $2,073.73 - $4,689.65 Biweekly 

Posting Closing Date: 08/07/2025 

Total Compensation Estimator Tool

Agency Overview:

The Agency for Health Care Administration (AHCA) is Florida's chief health policy and planning entity.

The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, and empowering consumers through health care transparency initiatives.

Under the direction of the Agency Secretary, AHCA is focused on advancing Governor DeSantis’ vision for Florida’s health care system to be the most cost-effective, transparent, and high-quality health care system in the nation.

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.

Agency Objectives:

HIGH QUALITY

Emphasizing quality in all that we do to improve health outcomes, always putting the individual first.

TRANSPARENT

Supporting initiatives that promote transparency and empower consumers in making well informed healthcare decisions.

COST-EFFECTIVE

Leveraging Florida’s buying power in delivering high quality care at the lowest cost to taxpayers.

Position Overview:

This is an exciting opportunity to help shape the quality of health care in Florida.

We are seeking to hire an AHC Administrator - 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 Bureau of Medicaid Policy.

Medicaid Policy is responsible for the development, coordination, and implementation of Florida Medicaid program policies, including: all Medicaid federal authorities (e.g. the Florida State Plan, 1115 waivers and home and community based waivers), administrative rules, coverage policies, managed care plan contracts, bill analyses, drug utilization review boards, preferred drug lists, supplemental rebate contracts, and KidCare/Title 21.

This position is responsible for leading and overseeing the Pharmacy Policy Section. 

This includes, but is not limited to, coordinating activities that include planning, directing, coordinating and implementing policy and program development functions for the Pharmacy Policy Section including overseeing policy regarding pharmacy services and the Florida Medicaid preferred drug list.

Responsibilities for this position include but are not limited to:

- Coordinating work and supervising employees.

- Maintaining up-to-date knowledge concerning the Florida Medicaid program, including pertinent Federal laws and regulations, state statutes and rules, the Florida Medicaid State Plan and its amendment processes, Medicaid Managed Care Waivers and Medicaid program manuals.

- Leading, developing, coordinating, and/or executing strategic planning activities for Medicaid Pharmacy Policy and the Florida Medicaid Preferred Drug list in order to assist in implementing goals, objectives and priorities of the Medicaid program.

- Planning, developing, and implementing policies and procedures related to Medicaid Pharmacy Policy and the Florida Medicaid Preferred Drug list, including handbook, rule and state plan amendment updates and changes.

- Acting as the liaison between the Bureau of Fiscal Agent Operations to ensure that the claims processing system has the correct edits and audits in order to adjudicate claims correctly.

- Assisting with the development of performance measures for the SMMC waivers, recommending program design modifications with regards to the SMMC program, policy language for the SMMC contracts and amendments, Dear Health Plan letters, policy transmittals, provider alerts, SMMC report guide.

- Assisting in coordinating clinical and claim system changes with the pharmacy benefit manager, including approval of coding changes for preferred/non-preferred products; updates to claim edits; and system generated prior authorization criteria, based upon clinical practice guidelines and Food Drug Administration (FDA) indications.

- Managing the Pharmaceutical and Therapeutics Committee (P&T) and the Drug Utilization Review (DUR) panel, including acquiring knowledge of specific products that will be presented to the P&T and DUR boards, and Assisting and attending the quarterly P&T and DUR board committee meetings, in addition to monitoring and assisting with administration of the federal and state supplemental rebate program.

- Ensuring 340B providers are labeled as such in the pharmacy system and sustaining an audit processes with respect to 340B pharmacy providers.

- Planning, organization, execution and coordination of program training and provision of technical assistance relating to Medicaid Pharmacy Policy and the Florida Medicaid Preferred Drug list, to ensure consistency in program operation and conformity with goals and objectives of the Agency and state and federal laws, rules, regulations and guidelines.

- Directing the appropriate planning, organization, execution and coordination of program evaluation activities to evaluate the efficiency and effectiveness of Medicaid Pharmacy Policy and the Florida Medicaid Preferred Drug list, and assess the achievement of goals, objectives and priorities of the Medicaid program related to the Medicaid program.

- Representing the Agency in local, state or national meetings, conferences, workshops and seminars related Medicaid Pharmacy Policy and the Florida Medicaid Preferred Drug list.

This position is not a remote or telework position.

A good attendance record is essential for any individual in this position as the work involved occurs daily and is time sensitive.  The individual in this position is expected to report to work daily and on time.

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:

• State Group Insurance Coverage Options, including health, life, dental, vision, and other supplemental insurance options;

• Flexible Spending Accounts;

• State of Florida retirement options, including employer contributions;

• Generous annual and sick leave benefits;

• 9 paid holidays a year and 1 Personal Holiday each year;

• Career advancement opportunities;

• Tuition waiver for courses offered by Florida’s nationally ranked State University System;

• Training and professional development opportunities;

• And more!

For more information about the Bureau of Medicaid Policy, please visit our website at http://ahca.myflorida.com/Medicaid/index.shtml.

Join us at the Agency for Health Care Administration in fulfilling our mission to provide “Better Health Care for all Floridians.”

KNOWLEDGE, SKILLS, AND ABILITIES

• Knowledge of the principles and techniques of effective communication.

• Knowledge of basic mathematics.

• Knowledge of research methods, principles and procedures.

• Knowledge of the techniques used in compiling and analyzing data.

• Ability to conduct research, program evaluation, or systems development.

• Ability to compile statistical data.

• Ability to review, analyze and evaluate statistical data.

• Ability to understand and apply laws, rules, regulations, policies and procedures.

• Ability to verify the accuracy of data.

• Ability to determine work priorities, assign work, and ensure proper completion of work assignments.

• Ability to solve problems and make decisions.

• Ability to plan and coordinate program activities.

• Ability to provide technical assistance and advice to health care staff.

• Ability to develop and present written analyses and reports relating to health care cost containment. 

• Ability to communicate effectively.

• Ability to establish and maintain effective working relationships with others.

• Ability to travel with or without accommodations.

MINIMUM QUALIFICATIONS REQUIREMENTS

- Two years of professional experience in the practice of pharmacy.

- Two years of supervisory experience.

- Two years of experience working with a Medicaid health plan or Pharmacy Benefits Manager (PBM).

- Preference will be given to candidates who have licensure as a Pharmacist in accordance with Florida Statute 465.

- Preference will be given to candidates who have at least 6 months experience working with or within a Medicaid program and with Managed Care plans.

- Preference will be given to candidates who have Pharmacy Policy experience within the last 5 years.

NOTE: The elements of the selection process may include a writing sample and will include an interview.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT: KIM QUINN 850-412-4277

BACKGROUND SCREENING

It is the policy of the Florida Agency for Health Care Administration that any applicant being considered for employment must successfully complete a State and National criminal history check as a condition of employment before beginning employment, and, if applicable, also be screened in accordance with the requirements of Chapter 435, F.S., and Chapter 408, F.S.  No applicant may begin employment until the background screening results are received, reviewed for any disqualifying offenses, and approved by the Agency.  Background screening shall include, but not be limited to, fingerprinting for State and Federal criminal records checks through the Florida Department of Law Enforcement (FDLE) and Federal Bureau of Investigation (FBI) and may include local criminal history checks through local law enforcement agencies.

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.