68063502 - PROGRAM ADMINISTRATOR - SES

Requisition No: 839223 

Agency: Agency for Health Care Administration

Working Title: 68063502 - PROGRAM ADMINISTRATOR - SES

 Pay Plan: SES

Position Number: 68063502 

Salary:  $2,245.19 Biweekly 

Posting Closing Date: 10/25/2024 

Total Compensation Estimator Tool

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 Program Administrator-SES position is anticipated to be filled at a rate of $2,245.19 bi-weekly and is non-negotiable. 

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 one of the bureau’s Tallahassee-based Prevention teams.

The Prevention Units also include Central and South-Florida based teams. 

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

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

The selected candidate will assist with the bureau’s fraud and abuse investigations, which include activities with legal and other procedural requirements.

The position is responsible for assisting MPI investigators, managers, and staff in the analysis and completion of investigations, typically focused on the imposition of administrative sanctions, payment restrictions, and referrals to other (external to MPI) AHCA offices; investigations may also lead to law enforcement referrals. 

Exceptional research and analytical abilities, along with keen communicative skills are a must for this exciting position.

The selected candidate will monitor investigative processes, participate in legal proceedings, and conduct and coordinate all aspects of preliminary investigations of suspected fraud or abuse. 

The incumbent will prepare and review settlement agreements, propose and prepare final orders, craft, and coordinate communications for the bureau.

The Program Administrator will make recommendations and assist in the implementation of policies, procedures, detection and investigative strategies, improving the bureau’s overall mission.

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/.  

KNOWLEDGE, SKILLS, AND ABILITIES

•Knowledge of Florida Medicaid

•Knowledge of Federal Medicaid

•Knowledge of Florida and Federal law related to Program Integrity

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

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

•Ability to determine work priorities, assign, work, and ensure proper completion of work assignments

•Ability to communicate effectively using written and verbal communication

•Ability to conduct fact finding research, conduct investigations activities, and accurately document information, conclusions, and findings

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

•Ability to demonstrate skills utilizing Microsoft Word, Excel, Outlook, PowerPoint, SharePoint

•Ability to travel with or without accommodations.

MINIMUM QUALIFICATIONS REQUIREMENTS

•  Two years of investigative, enforcement, health care, or professional experience in a position within a regulatory, or oversight setting.

•  One year of supervision and/or managerial experience.

•  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: 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.