68024066 - AGENCY FOR HEALTH CARE ADMINISTRATOR-SES

Requisition No: 840439 

Agency: Agency for Health Care Administration

Working Title: 68024066 - AGENCY FOR HEALTH CARE ADMINISTRATOR-SES

 Pay Plan: SES

Position Number: 68024066 

Salary:  $2,033.07 - $2,621.28 Biweekly 

Posting Closing Date: 11/13/2024 

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This is a full-time Selected Exempt Service (SES) management position, with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5 p.m. 

This AHC Administrator-SES position is anticipated to be filled at a rate of $2,033.07 - $2,621.28 bi-weekly based on the selected candidate’s experience. 

This position may involve travel related activities from 1-25%. 

Successful completion of a criminal background investigation is a condition of employment.

The Florida Medicaid program is one of the five largest in the country with an estimated $35 billion annual budget.  Each month Florida Medicaid covers medical services for over 5 million recipients. 

To effectively serve this large patient population, one of the Agency goals is to ensure fewer budgeted dollars are lost to fraud, abuse, and waste. 

The Bureau of Medicaid Program Integrity (MPI) does this specifically through audits and investigations of Medicaid providers, including managed care plans. 

MPI also imposes administrative sanctions for program violations and refers suspected fraud or other criminal violations to appropriate law enforcement agencies for further investigation.

MPI operates with dynamic and fast-paced units that work closely together to serve the overall bureau mission. 

MPI units are responsible for developing novel methods and innovative solutions necessary to address the complexity and scope of fraudulent and abusive behavior in the Florida Medicaid program. 

These highly collaborative units rely on teams with diverse educational and experience backgrounds.

The selected candidate will be responsible for the effective management of team members in the bureau’s budget and personnel office located in the Operations Unit. 

This supervisor is responsible for recruiting, hiring, and evaluating the performance of program staff and OPS personnel, as well as motivating, training, planning, and directing employees’ work assignments. 

This will include communication, motivation, training and evaluating employees; planning, and coordinating the work initiatives of staff to ensure the timely and efficient performance of assigned duties.  

The selected candidate will be responsible for the effective operational management, maintenance, and oversight of the MPI budget, including the preparation and submission of spend plans, allocation requests, legislative budget requests, evaluation and decision-making regarding purchase requests and budget availability. 

This is to include the monitoring and adjusting monthly expenditures to ensure MPI stays within budget guidelines.  Works closely with Financial Services to address any unexpected issues that arise, such as litigation expenses, legal settlements, legislative mandates, audit expenses and other expenditures; and makes recommendations and appropriate adjustments. 

Works closely with Bureau Chief in the administration of the budget, purchasing, personnel and building operations.

The selected candidate will also assist in maintaining personnel records and reports for MPI ensuring that they conform to agency and Department of Management Services standards. 

Assist in the coordination of personnel actions for the bureau including the preparation of required forms and reviewing the hiring process to ensure compliance with personnel requirements. 

Advises management staff on the proper procedure for personnel actions.  Serves as liaison with Agency human resources and other State Agency human resource departments. 

Provide and maintain personnel activity updates on hiring, vacancies, organizational charts, phone lists, and floor plans, and assisting in the monitoring and providing People’s First assistance with timesheets, annual evaluations, probationary evaluation periods, hiring process, and other personnel related issues through notification and training. 

The incumbent will direct the preparation and submission of the Agency’s Annual Report, “Florida’s Efforts to Control Medicaid Fraud and Abuse” to the Legislature documenting the effectiveness of the state’s efforts to control Medicaid fraud and abuse during the previous fiscal year and will serve as the audit liaison for MPI and in that capacity functions as the central point of contact for all audit related requests, internal and external. 

The incumbent will also assist in coordinating training activities including conferences for the Bureau, developing, and implementing staff training and educational programs.

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

For more information on MPI, please visit MPI at: http://ahca.myflorida.com/MCHQ/MPI/index.shtml. 

KNOWLEDGE, SKILLS, AND ABILITIES

•Federal Medicaid

•Florida Medicaid

•Florida Law Related to Program Integrity

•Federal Law Related to Program Integrity

•Florida Program Integrity Procedure

•Principles of Program Integrity 

•Principles of Investigations

•Theory and Principles of Fraud and Criminology.

•Personnel management and related supervisory techniques.

•Computer software programs such as MS Office.

•General office administration and bureau operations both generally and in detail specific to the assigned unit.

•Knowledge of Florida Statutes, rules, policies, and procedures relating to budget, purchasing, and human resources for the   State of Florida and the Agency

•Knowledge of FLAIR, MyFloridaMarketPlace, People First, and the Statewide Travel Management System

•Knowledge of Microsoft Office applications; Word, Excel, PowerPoint, and Adobe, Visio, SharePoint

•Ability to solve problems and make decisions based on available information

•Ability to execute projects and assignments timely and accurately within a fast-paced environment

•Ability to work independently

•Ability to communicate effectively verbally and in writing

•Ability to handle sensitive data and communication

•Ability to plan, organize and coordinate work assignments

•Ability to analyze, evaluate and interpret financial data as it relates to purchasing activities and personnel actions

•Ability to travel with or without accommodations.

MINIMUM QUALIFICATIONS REQUIREMENTS

•Three years of professional work experience which demonstrates leadership and personnel management capability, at least two of which is professional experience in a supervisor position.

•Three years professional work experience in a position with duties related to prevention, detection, or investigation of fraud, abuse, or waste in health care, and/or professional work experience in a position within a regulatory, or health services setting.

•Preference is given to candidates with a graduate degree from an accredited college or university in one of the following disciplines: health law; health sciences; health services administration; business administration; public administration; education; political science/government relations; or a substantially similar discipline, such as criminology or criminal justice.

•Preference is given to candidates with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified Financial Crimes Investigator; Certified Insurance Fraud Investigator; or Certified Compliance and Ethics Professional.

•Additional professional experience beyond three years can substitute on a year-for-year basis for the preferred college education, described above.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT: HELEN GUNN 850-412-4626

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.