68055647 - MEDICAL/HEALTH CARE PROGRAM ANALYST

Requisition No: 863420 

Agency: Agency for Health Care Administration

Working Title: 68055647 - MEDICAL/HEALTH CARE PROGRAM ANALYST

 Pay Plan: Career Service

Position Number: 68055647 

Salary:  $1,833.39 Biweekly 

Posting Closing Date: 10/31/2025 

Total Compensation Estimator Tool

This is a full-time career service position, with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5:00 p.m.

This Medical Health Care Program Analyst position is anticipated to be filled at a rate of $1,833.39 b/w and is non-negotiable.

This position may involve travel-related activities from 1-15%. 

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

A good attendance record is essential for any individual in this position as the work involved occurs daily and is time sensitive.

The individual in this position is expected to report to work daily and on time.

The Agency for Health Care Administration is seeking to fill a Medical Health Care Program Analyst position within the Bureau of Medicaid Program Integrity (MPI).

MPI is the Agency’s lead unit responsible for oversight of Medicaid fraud, waste, and abuse, and ensure compliance with applicable laws, rules, and contractual requirements.

This Medical Health Care Program Analyst position will report to a supervisor in the Overpayment Recoupment Unit (Institution) within MPI for the purposes of analyzing and auditing Medicaid providers. 

Key responsibilities include conducting data and programmatic analyses, performing desk audits, coordinating with internal staff and peer reviewers, and collaborating with attorneys to support and defend work products throughout the judicial process.

MPI seeks applicants who are able to demonstrate strong auditing or investigative, research, and organizational skills, as well as having up-to-date knowledge of the Florida Medicaid program and be able to accurately apply software programs needed to complete investigations and audits.

Applicants should also possess the ability to review and comprehend applicable federal and state laws, rules, and policies related to health care and enforcement activities.

This knowledge will be needed to assist MPI in appropriately conducting audits, making referrals to other entities, recovering overpayments, applying administrative sanctions, and processing final orders involving Medicaid providers.

MPI offers a multitude of training opportunities for all MPI employees to enhance their professional growth. 

MPI is undergoing some exciting changes and the candidate will be involved in activities of a broader nature within the Agency to support the Agency’s overall mission.

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

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/

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.

•Ability to demonstrate proficiency using Microsoft Word, Excel, Outlook, PowerPoint, SharePoint.

•Ability to travel with or without accommodation.

•Knowledge of the Florida Medicaid Program.

•Knowledge of research or investigative principles, practices, and techniques.

MINIMUM QUALIFICATIONS REQUIREMENTS

•Two years of professional or nonprofessional experience in a regulatory or health service setting.

•An associate’s degree from an accredited college or university can substitute on a year-for-year basis in a related field such as: health law, health science, health services administration, business administration, public administration, sociology, 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; Certified Compliance and Ethics Professional, or other relevant certification, such as: Project Management Professional.

•Preference will be given to candidates with professional experience in business, data, or information analysis.

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.

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.