68021778 - GOVERNMENT OPERATIONS CONSULTANT III

Requisition No: 833538 

Agency: Agency for Health Care Administration

Working Title: 68021778 - GOVERNMENT OPERATIONS CONSULTANT III

 Pay Plan: Career Service

Position Number: 68021778 

Salary:  $1,907.11 - $2,016.38 Biweekly 

Posting Closing Date: 01/11/2025 

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 a Government Operations Consultant III 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 development of policy language for Statewide Medicaid Managed Care (SMMC) Plan Communications (i.e., Dear Managed Care Plan letters, contract interpretations, policy transmittals, and provider alerts); processing Medicaid Managed Care Plan Report Guide revisions; and updating and/or requesting updates to SMMC webpages (https://ahca.myflorida.com/Medicaid/statewide_mc/index.shtml) as directed. 

The incumbent will track and monitor the routing and approval of all the aforementioned policy documents to ensure timely completion and adherence to Agency established deadlines.

Examples of tasks the incumbent may be asked to do include, but are not limited to:

*Interpret policy documents and develop written guidance to SMMC plans, such as: https://ahca.myflorida.com/medicaid/statewide_mc/mcp_plan_comunications_archive.shtml

*Create contract language, such as: https://ahca.myflorida.com/medicaid/statewide-medicaid-managed-care/2018-2024-model-health-plan-contract

*Simplify policies to create program highlight documents such as: https://ahca.myflorida.com/Medicaid/statewide_mc/pdf/mma/COC_Program_Highlight_122018.pdf 

An ideal candidate will be able to:

*Acquire and maintain up-to-date knowledge of the Florida Medicaid program, including pertinent Federal laws and regulations, state statutes and rules.

*Utilize fine-tuned research skills to provide consultative information to internal and external stakeholders.

*Execute projects, assignments, and policy updates timely and accurately within a fast-paced environment.

* Provide consultation and expert advice to leadership using logic and analysis to identify the strengths and weaknesses of different approaches.

*Communicate effectively both verbally and in writing.

*Establish and maintain effective working relationships with others.

*Function both independently and in a team environment.

*Be flexible to function and succeed both with and without extensive direction.

*Determine work priorities and ensure proper completion of work assignments.

*Communicate, correspond, and provide trainings/presentations to both internal and external inquirers.

Research

The incumbent shall:

- Maintain up-to-date knowledge concerning all aspects of the Florida Medicaid program, including federal regulations, state statutes, administrative rules, and the Florida Medicaid State Plan.

- Maintain up-to-date knowledge of health care and relevant industry trends that may have an impact on Florida Medicaid or may inform policy development activities.

- Remain informed about the operations of the Medicaid fiscal agent, including Medicaid claims process, billing procedures, reimbursement methodologies, encounter submissions, and provider enrollment.

- Remain informed about Medicare policies, national Medicaid-related research and demonstration projects, Medicaid Medical Assistance program innovations for general and special populations, and alternative financing and service delivery systems models.

- Conduct research on assigned topics, including, but not limited to, performing a review of peer-reviewed research articles, federal and state laws, other reliable sources of evidence, the Medicaid State Plan, Agency communications, State Medicaid Director Letters, and vendor contracts.

Program Planning and Analysis

The incumbent shall:

- Analyze health care/program related information (including alternative financing and reimbursement strategies) in order to determine the effect on the Florida Medicaid program and compliance with federal and state laws.

- Assist in the analysis and development of programmatic and fiscal impact statements based on proposed federal/state program or policy changes.

- Prepare reports of research findings, including synthesizing complex and/or large amounts of information into a useful format and presentation.

- Assist in the development of legislative budget requests and program proposals.

- Assist in the development of grant proposals.

- Assist in the completion of legislative reports, including collection of necessary data elements.

- Assist in the development and implementation of program designs, projects, and/or plans in order to meet bureau goals/priorities.

- Participate, and contribute to, formal and informal project teams, as assigned.

Policy Development

The incumbent shall:

- Develop and maintain program policies and procedures under the Florida Medicaid program to ensure that programs operate in accordance with the goals and objectives of the Agency, state and federal laws, rules, regulations, and guidelines.

- Assist in the development of policy language for: the Medicaid managed care report guide, Medicaid contracts and amendments; Dear Managed Care Plan letters, contract interpretations, policy transmittals, and provider alerts.

- Track and monitor the routing and approval of all policy documents to ensure timely completion and adherence to Agency established deadlines.

- Submit approved policy documents for publication on the appropriate Agency webpages, as required.

Communication

The incumbent shall:

- Assist in the development of training and providing technical assistance to ensure consistency in service/program operation and conformity with goals and objectives of the Agency, state and federal laws, rules, regulations, and guidelines.

- Identify and document training needs.

- Design and evaluate training programs and materials.

- Conduct statewide and local trainings, as required.

- Provide technical assistance regarding service/program policies and procedures to both internal and external stakeholders.

- Provide consultation through the accurate presentation of data and other service/program information.

- Participate on behalf of the Agency in local, state, or national meetings, conferences, workshops, and seminars related to the Florida Medicaid program.

- Prepare presentation materials, as assigned.

Contract Development

The incumbent shall:

- Receive and route for approval, requests for contract amendments.

- Develop and route for execution, standard contract documents and amendments.

- Track and monitor progression of contracts and amendments through Agency's formal contract tracking system.

- Carry out other necessary contract development activities.

This position may require travel.

Salary will be commensurate with experience.

All applicants must ensure that all employment and detailed information about work experience is listed on your applicant profile and/or resumé (including dates of service, reason for leaving, military service, self-employment, job-related volunteer work, internships, etc.) and that gaps in employment are explained.  Applicants who do not provide all information necessary to meet the minimum requirements will not be considered for this position.

This position is not a remote or telework position; it will have to report to a Field Office or the Headquarters in Tallahassee.

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 basic management principles and practices.

Knowledge of the methods of data collection and analysis.

Ability to coordinate a consultative program designed to ensure the resolution of managerial and operational problems.

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

Ability to communicate effectively.

Ability to establish and maintain effective working relationships with others.

Ability to assess budgetary needs.

Ability to formulate policies 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 presentation in reports, documents, and other written materials.

Ability to collect, evaluate and analyze data to develop alternative recommendations, solve problems, document work and other activities relating to the improvement of operational and management practices.

Ability to conduct fact-finding research.

Ability to work independently.

Ability to solve problems and make decisions.

Ability to travel with or without accommodation.

MINIMUM QUALIFICATIONS REQUIREMENTS

Two years of experience using Microsoft Office Suites.

Two years of experience developing State or health care related policies.

Two years of experience developing and writing high-level communications/documents for external distribution and/or public webpage posting.

At least a four (4) year (bachelor's) degree from an accredited college or university is preferred and can substitute for the required experience.

Preference will be given to applicants who holds a current Florida Certified Contract Manager (FCCM) certification.

Preference will be given to candidates with professional writing experience (e.g., policy development, grant writing/submissions, rule promulgation, research publications, white papers, etc.).

NOTE:  The selection process may include a writing sample.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT:  WENDI SMITH 850-412-4138

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.

VETERANS’ PREFERENCE.  Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans’ Preference will receive preference in employment for Career Service vacancies and are encouraged to apply.  Certain service members may be eligible to receive waivers for postsecondary educational requirements.  Candidates claiming Veterans’ Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code.  Veterans’ Preference documentation requirements are available by clicking here.  All documentation is due by the close of the vacancy announcement.