68046727 - MEDICAL/HEALTH CARE PROG ANALYST

Requisition No: 70189 

Agency: Agency for Health Care Administration

Working Title: 68046727 - MEDICAL/HEALTH CARE PROG ANALYST

Position Number: 68046727 

Salary:  $1,574.93 / Bi-Weekly 

Posting Closing Date: 08/26/2019 

This is a vacancy for a Career Service Medical Health Care Program Analyst position to be filled at $40,948.18 a year. This is a salaried position for a highly responsible individual requiring the selected candidate to work 40 hours per week, Monday through Friday, 8:00 am to 5:00 pm, with 1-15% travel. Successful completion of a criminal background investigation is a condition of employment.

This position reports to the Program Administrator supervising the Intake Unit and will support the fraud and abuse detection and prevention efforts within the Bureau of Medicaid Program Integrity (MPI), through assessment and preliminary investigation of complaints regarding Medicaid fraud and abuse.  Personnel in this unit are expected to timely and accurately utilize information from several Agency databases, to conduct reviews, analysis, and investigations regarding a high volume of complaints.

This candidate will participate in the complaint intake and review process, including receipt of the complaint, gathering information to conduct an assessment, making a determination to proceed with a preliminary investigation, writing a plan for the preliminary investigation, recommending a course of action, and working with other team members, to share information and collaborate on projects or assignments.  Applicants should possess the ability to review and comprehend applicable federal and state laws, rules, and policies related to health care and enforcement activities, demonstrate the ability to utilize data analysis techniques, coordinate investigative activities, and accurately document the results with strong writing skills.

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

KNOWLEDGE, SKILLS, AND ABILITIES

• Must be proficient with and have a working knowledge of Microsoft Word, Excel, Outlook, and Internet Explorer.
• Must demonstrate strong organizational skills, research skills, and written and oral communication skills.
• Must demonstrate the ability to coordinate investigative activities and clearly and accurately document the result of your work in a written summary.
• Must demonstrate ability to review and comprehend applicable federal and state laws, rules, policies, and regulations related to health care and enforcement activities.
• Must be able to manage a large workload and multiple assignments daily along with changing priorities.
• Must be highly discreet and committed to protecting sensitive and confidential information.
• Ability to travel with or without accommodations.

MINIMUM QUALIFICATION REQUIREMENTS

• Two years of professional work experience related to prevention, detection, and/or investigation of fraud, abuse, and waste in a health care system, and/or professional work experience in an educational or health services setting.

 
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 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; or Certified Insurance Fraud Investigator.
 
Professional experience as described above, can substitute on a year-for-year basis for the preferred college education.
 
LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS
N/A
 
CONTACT: SANDY KING 850-412-4600

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.  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.