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68039486 - AGENCY FOR HEALTH CARE ADMINISTRATOR-SES

Date: Mar 31, 2021

Location: TALLAHASSEE, FL, US, 32308

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Requisition No: 338741 

Agency: Agency for Health Care Administration

Working Title: 68039486 - AGENCY FOR HEALTH CARE ADMINISTRATOR-SES

Position Number: 68039486 

Salary:  $1,783.89 - $4,159.53 / Bi-Weekly 

Posting Closing Date: 04/13/2021 

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 position is anticipated to be filled at a rate of $46,381.14 - $108,147.74 per year 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 and has an estimated $30 billion annual budget. Each month Florida Medicaid covers medical services for almost 4 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 personnel management of the Prevention Strategy Unit and is expected to have routine communication with and provide clear guidance to team members. This administrator is responsible for meeting with his or her direct reports individually to encourage their professional development, and as a group to ensure optimum unit performance.  This administrator is also 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.

 

The selected candidate will also be responsible for the effective operational management of the Prevention Strategy Unit and will supervise a team of investigators and analysts who are responsible for conducting preliminary investigations, writing investigative summary reports, making referrals to other bureaus and entities, applying administrative sanctions and payment restrictions, and processing final orders involving Medicaid providers. The selected candidate will be responsible for working collaboratively with team members and managers in other MPI operational units, participating in on-site activities and field initiatives, and coordinating special projects, as needed.

 

MPI provides a multitude of training opportunities for all MPI employees to enhance their professional growth.  This position 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

 

For more information, please view MPI's section of "Florida's Efforts to Control Medicaid Fraud and Abuse FY 2018-2019" located at: http://ahca.myflorida.com/MCHQ/MPI/docs/FraudReports/FraudReport2018-19.pdf

 

KNOWLEDGE, SKILLS, AND ABILITIES

  • 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 conduct investigations, coordinate investigative activities, and accurately document the result of an investigation.
  • Ability to conduct fact finding research.
  • Ability to work independently.
  • Ability to communicate effectively verbally and in writing
  • Ability to review and comprehend applicable federal and state laws, rules, policies, and regulations related to health care and enforcement activities.
  • Knowledge of the Florida Medicaid Program.
  • Knowledge of Microsoft features including, Word, Excel, Outlook, and Internet Explorer.
  • Knowledge of research or investigative principles, practices, and techniques.
  • Possess investigative skills, research skills, written and oral communication skills, and organizational skills.
  • Ability to travel with or without accommodations.

 

MINIMUM QUALIFICATION REQUIREMENTS

  • Four years of investigative, enforcement, health care, or professional experience in a position within an educational, regulatory, or oversight setting.
  • Two years of leadership and management experience in a position within the Medicaid, Healthcare or regulatory arena.

 

Preference will be given to candidates with a bachelor's degree or higher from an accredited college or university, particularly in a related field such as: health law, health science, criminology, criminal justice, or a substantially similar discipline.

 

Preference will be 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.

 

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

 

CONTACT: STERLING ABNEY 850-412-4645

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