68064859 - MEDICAL/HEALTH CARE PROGRAM ANALYST

Requisition No: 853299 

Agency: Agency for Health Care Administration

Working Title: 68064859 - MEDICAL/HEALTH CARE PROGRAM ANALYST

 Pay Plan: Career Service

Position Number: 68064859 

Salary:  $1,794.92 - $2,333.40 Biweekly 

Posting Closing Date: 05/25/2025 

Total Compensation Estimator Tool

Agency Overview:

The Agency for Health Care Administration (AHCA) is Florida's chief health policy and planning entity.

The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, and empowering consumers through health care transparency initiatives.

Under the direction of the Agency Secretary, AHCA is focused on advancing Governor DeSantis’ vision for Florida’s health care system to be the most cost-effective, transparent, and high-quality health care system in the nation.

The Medicaid program provides low-income families and individuals with access to health care. 

If you have a desire to use your talent and skills at an organization that provides critical services to millions of individuals and families across the state, AHCA invites you to apply to become an essential member of our team.

As one of Florida’s leading state agencies, AHCA’s diverse workforce community of more than 1,400 employees is proud of its efforts to serve the people of Florida.

Agency Objectives:

HIGH QUALITY

Emphasizing quality in all that we do to improve health outcomes, always putting the individual first.

TRANSPARENT

Supporting initiatives that promote transparency and empower consumers in making well informed healthcare decisions.

COST-EFFECTIVE

Leveraging Florida’s buying power in delivering high quality care at the lowest cost to taxpayers.

Position Overview:

This is an exciting opportunity to help shape the quality of health care in Florida.

We are seeking to hire a Medical/Health Care Program Analyst who desires to work to enhance the delivery of health care services through the Florida Medicaid Program. 

This position requires a candidate who is creative, flexible, innovative, and who will thrive in a fast-paced, team based work environment.

This position is located in the Bureau of Medicaid Fiscal Agent Operations (MFAO).

MFAO serves as the primary organizational unit within the Agency to provide oversight and monitoring of the Agency’s Medicaid fiscal agent; responsible for the processing of Florida Medicaid claims and multiple supporting systems; ensuring Medicaid providers are properly enrolled into the program, Medicaid recipients receive proper coverage, enrollment into managed care plans; extracting, analyzing, and/or reporting Medicaid data; and ensuring that new Agency systems are planned and procured.

This position is responsible for :

- Coordinating with the Bureau of Recipient and Provider Assistance regarding site visits on initial and renewal Medicaid applications. 

- Processing and generating file maintenance requests to update Medicaid provider information.

- Overseeing workflow between the Provider Enrollment Unit and Medicaid's fiscal agent.

- Coordinating with Medicaid Program Finance to establish rate settings for providers.

- Conducting research utilizing various Agency and non-agency resources.

- Helping resolve escalated issues related to Medicaid provider enrollment as directed by managers.

- Providing research assistance and Medicaid enrollment/eligibility information to other state agencies and AHCA bureaus.

- Replying to denied, terminated, and suspended Medicaid providers or applicants utilizing standard/approved language that protects and supports the Florida Medicaid Program.

- Processing standard and complex Changes of Ownership and communicating with legal liassons.

- Possessing and maintaining up-to-date knowledge concerning the Florida Medicaid Program, including the Florida Medicaid Management Information System (FMMIS), pertinent state and federal laws and administrative rules and codes governing state and federal healthcare programs, Medicaid provider handbooks and Medicaid provider enrollment procedures.

Also, the Incumbent shall possess outstanding organizational and formal writing skills.

A skills test may be conducted at the interview.

This position is not a remote or telework position.

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 more information about the Bureau of Medicaid Fiscal Agent Operations, please visit our website at http://ahca.myflorida.com/Medicaid/index.shtml.

Join us at the Agency for Health Care Administration in fulfilling our mission to provide “Better Health Care for all Floridians.”

KNOWLEDGE, SKILLS, AND ABILITIES

Excellent communication skills, written and verbal.

Ability to work well in a team environment and lead team members to produce successful outcomes.

Strong analytical, research and critical thinking skills.

Working knowledge and familiarity with Microsoft Office products.

Ability to self-motivate, operate independently, reasonably, and decisively with limited supervision.

Ability to self-manage workload by prioritization and respond to immediate needs of management.

Knowledge of state and federal health care procedures, programs and regulation.

Capacity to write and prepare system, application and user documentation in various formats including Excel.

Ability to collect, evaluate and analyze data

Ability to organize data into a logical format for presentation in reports, documents and other written material

Ability to utilize problem-solving techniques and make decisions independently

MINIMUM QUALIFICATIONS REQUIREMENTS  

Two years of experience in either a state regulatory setting or health care setting relating to data processing and analysis, quality control, and/or customer service.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT: CARISSA BAXTER 850-412-3440

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.