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68900173 - OPS REGULATORY ANALYST II

Date: Oct 16, 2020

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

Requisition No: 250344 

Agency: Agency for Health Care Administration

Working Title: 68900173 - OPS REGULATORY ANALYST II

Position Number: 68900173 

Salary:  $17.00 / Hourly 

Posting Closing Date: 10/29/2020 

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 an OPS Regulatory Analyst II 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.

 

The position is located in the Provider Eligibility and Compliance Unit within the Bureau of Medicaid Fiscal Agent Operations. This bureau is responsible for monitoring DXC Technology, Medicaid's Fiscal Agent. The Provider Eligibility and Compliance Unit is responsible for ensuring the eligibility and compliance with Medicaid Program Requirements for both active Medicaid providers and prospective Medicaid providers who have submitted enrollment applications. The unit also plays a key role as a liaison between Medicaid Provider Enrollment and Medicaid Program Integrity and handles communications and data between the Agency and the Centers for Medicaid & Medicare Services (CMS).

 

This position is responsible for screening, investigating, and performing risk assessments on incoming Medicaid Provider Enrollment applications submitted for provider types that present an elevated risk for Medicaid fraud and abuse; processing without-cause provider contract terminations; processing and reviewing the impact of final orders and federal healthcare program exclusions on providers that are enrolled in or previously enrolled in Florida Medicaid; further investigating correlations to termination requests received from the Agency for Persons with Disabilities; working reports generated by and stored within the OnBase document storage system; and performing file maintenance and provider enrollment file cleanup tasks as needed.

 

AHCA offers an excellent array of benefits, including:                     

  • Health insurance
  • Life insurance
  • Dental, vision and supplemental insurance        
  • Opportunities for career advancement
  • Training opportunities

 

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.”

 

CONTACT: DEBORAH KELLEY 850-412-3449

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.


Nearest Major Market: Tallahassee