68022049 - REGISTERED NURSING CONSULTANT

Requisition No: 885936 

Agency: Agency for Health Care Administration

Working Title: 68022049 - REGISTERED NURSING CONSULTANT

 Pay Plan: Career Service

Position Number: 68022049 

Salary:  $1,988.63 - $2,585.22 Biweekly 

Posting Closing Date: 11/02/2026 

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 Registered Nurse Consultant 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 Quality. Medicaid Quality provides data-driven, focused and systematic feedback on the quality of Florida’s Medicaid program to federal and state agencies, Medicaid recipients, Medicaid managed care plans, and providers.

The Bureau of Medicaid Quality has a strong focus on providing more comprehensive care, improving health outcomes, and reducing costs.

This position is responsible for performing clinical monitoring and quality assurance of the Florida Medicaid program as follows:

• Coordinate and perform monitoring activities (routine and ad-hoc reviews) in accordance with Florida Medicaid policies and procedures, as directed by the incumbent's supervisor.

• Design and develop monitoring tools and protocols.

• Coordinate and implement monitoring plans and protocols for the review and analysis of program policies and procedures through health plan and provider monitoring.

• Conduct desk/on-site monitoring reviews of health plans, providers, and other entities as required.

• Complete reports of monitoring findings and recommend corrective actions.

• Conduct follow-up activities to ensure areas of non-compliance identified through the monitoring activities are remediated, as appropriate.

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

• Maintain up-to-date knowledge of health care and relevant industry trends that may have an impact on Florida Medicaid or may inform quality improvement 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 and Medicaid policies, research and demonstration projects, program innovations for general and special populations, and alternative financing and service delivery systems models.

• Conduct research on assigned topics.

• Analyze health care/program related information in order to determine compliance with federal and state laws.

• Prepares reports, including data to support conclusions, evaluating the impact, efficiency, and effectiveness of programs.

• Synthesize the results of monitoring activities that has occurred over time into a useful format and presentation and that illustrates trends of health plan/provider performance.

• Develop grant proposals, as requested.

• Coordinate and conduct special studies and makes recommendations concerning program design and development.

• Provide independent clinical consultation and use of his/her clinical judgment in the performance of monitoring activities.

• Consults with the unit supervisor in employing professional nurses.

• Consults with other program personnel on nursing/medical matters affecting the overall operations of the program.

• Prepare correspondence to entities for which a monitoring review will be conducted to relay key information needed to complete the review.

• Ensure that all written materials (reports, correspondences, presentations, etc.) are of good quality and comply with Agency and bureau style guide requirements.

• Develop training and technical assistance to internal and external stakeholders to ensure consistency in service/program operation and conformity with goals and objectives of the Agency, state and federal laws, rules, regulations, and guidelines.

• Develop, coordinate, and implement local or statewide training, as required.

• Identify and document clinical/medical training needs of health plans and providers based on monitoring activities.

• Design and evaluate training programs and materials.

• Escalate areas of concern related to monitoring activities to the incumbent's supervisor.

• 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.

This position is not a remote or telework position.

Benefits of working for the State of Florida:

Working for the State of Florida is more than a paycheck. We offer an excellent array of benefits, including:

•              Health insurance (i.e., individual and family coverage) to eligible employees

•              Life insurance; $25,000 policy is free plus option to purchase additional life insurance

•              Dental, vision and supplemental insurance

•              State of Florida retirement options, including employer contributions

•              Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida

•              Ability to earn up to 104 hours of sick leave annually

•              Nine paid holidays and 1 personal holiday each year

•              Opportunities for career advancement

•              Tuition waivers (accepted by major Florida Colleges/universities)

•              Student loan forgiveness opportunities (eligibility required)

•              Training opportunities

•              Flexible Spending Accounts

•              Shared Savings Program for select medical services

•              Lower copays for prescription drugs

•              Health and Wellness discounts

For a more complete list of benefits, please visit https://www.mybenefits.myflorida.com/

For more information about the Bureau of Medicaid Quality, 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 nursing principles, practices and techniques.

 •  Knowledge of human anatomy and physiology.

 •  Knowledge of methods of compiling, organizing and analyzing data.

 •  Ability to develop and implement various program monitoring methodologies and techniques.

 •  Ability to provide in-service training on medical and health care services, patient assessments, and utilization practices.

 •  Ability to develop program policy, procedures, manuals, administrative rules and agreements.

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

 •  Ability to prioritize workload.

 •  Ability to plan, organize and coordinate work assignments.

 •  Ability to develop various reports.

 •  Ability to formulate and monitor nursing standards and operating policies and procedures.

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

 •  Ability to communicate effectively.

 •  Ability to travel with or without accommodations.

MINIMUM QUALIFICATIONS REQUIREMENTS

Four years of professional nursing experience, two years of which must have been in a supervisory or administrative capacity.

Preferred Qualification:

A Bachelor of Science in Nursing (BSN) degree is preferred from an accredited college or university.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

Licensed as a Registered Nurse in accordance with Chapter 464, Florida Statutes

CONTACT: MEAGAN OWENS 850-412-4232

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.

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.