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68064880 - MEDICAL HEALTH CARE PROGRAM ANALYST

Date: Apr 6, 2021

Location: TALLAHASSEE, FL, US, 32308

The State Personnel System is an E-Verify employer. For more information click on our E-Verify website.

Requisition No: 338743 

Agency: Agency for Health Care Administration

Working Title: 68064880 - MEDICAL HEALTH CARE PROGRAM ANALYST

Position Number: 68064880 

Salary:  $1,574.93 / Bi-Weekly 

Posting Closing Date: 04/12/2021 

This is an exciting opportunity to help shape the quality of health care in Florida. The Agency for Health Care Administration (AHCA) is the State of Florida agency responsible for oversight of the Medicaid program.  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.

           

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 Plan Management Operations (PMO). PMO is responsible for the primary oversight of Medicaid’s managed care programs, with a focus on the Statewide Medicaid Managed Care (SMMC) program. The bureau’s primary responsibility is ensuring that the managed care plans meet Medicaid contractual requirements, including the timely provision of medically needed services and provider payment for such services.

 

This position is responsible for reviewing, analyzing, and monitoring managed care plan subcontracts and subcontracted services. This work consists of conducting studies and evaluations, developing reports, conducting work simplifications and measurement studies, providing technical assistance and developing operations and procedures to assist the Agency in operating more efficiently and effectively (which may include program analysis, management consulting, and examination development).  This position serves as the lead point of contact for subcontractor oversight working closely with the Agency's contract managers responsible for the Medicaid managed care plan contract(s).

 

The incumbent in this position maintains up-to-date knowledge concerning the Florida Medicaid program by researching and analyzing pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State Plan, federal managed care waivers, and Medicaid policies. The incumbent remains informed about regulations of the Agency for Health Care Administration, managed care contracts, as well as Medicaid systems and technology, and Medicaid-related activities of the Agency. The incumbent maintains knowledge about Agency operating procedures and processes.

 

The incumbent conducts strategic program planning activities in order to promote access to care, improve the quality of care and increase the efficiency and cost-effectiveness of the Medicaid program related to the managed care programs and contracts.

 

The incumbent plans, organizes and coordinates the program monitoring activities for Medicaid managed care plans' subcontractors, including oversight analysis to identify managed care plan compliance issues and problems.  The incumbent provides guidance and counsel to Plan Management leadership and their staff by analyzing results and findings and developing compliance actions as prescribed in the managed care contract (e.g., corrective action plans, sanctions, liquidated damages, etc.) and completing follow-up investigation to ensure compliance with the managed care plan contract and Medicaid policies and procedures. 

 

The incumbent conducts program training and provides technical assistance related to Medicaid managed care plans' subcontractor requirements, in order to ensure consistency in program operation and conformity with goals and objectives of the Agency and state and federal laws, rules, regulations and guidelines.

 

The incumbent in this position may be required to analyze proposed state and federal legislation, rules, regulations and policies to determine the impact on Medicaid including: conducting bill analyses, analyzing federal and state legislation, drafting Legislative Budget Requests, drafting managed care legislation, developing presentation materials, and responding to Legislative requests for information. The incumbent assists in the completion of legislative reports as required.

 

AHCA 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 about the Bureau of Plan Management 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

  • Knowledge of the Medicaid Program and Managed Care.
  • Knowledge of the methods of data collection and analysis.
  • Ability to develop tracking systems, maintain accurate information within tracking systems, and coordinate the gathering of information from various sources.
  • Ability to organize data into logical formats for presentation in reports, documents and other written materials.
  • Ability to conduct fact-finding research.
  • Ability to work independently.
  • Ability to understand and apply applicable rules, regulations, policies and procedures relating to plan management activities.
  • Ability to plan, organize, coordinate and complete work assignments.
  • Ability to communicate effectively.
  • Ability to establish and maintain effective working relationships with others.
  • Ability to travel with or without accommodations.
  • Ability to work with Microsoft Suite; proficient in Microsoft Word, Excel, Outlook and Internet Explorer.

 

MINIMUM QUALIFICATION REQUIREMENTS

  • At least one (1) year of work experience in Medicaid and/or a Managed Care Organization.
  • At least one (1) year of experience working with contract or program related activities (e.g. compliance reviews, providing technical assistance).

 

At least one (1) year of experience analyzing data preferred.

 

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

 

CONTACT: SARAH CHEATHAM 850-412-4032

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. 


Nearest Major Market: Tallahassee