68900274 - OPS MEDICAL/HEALTH CARE PROGRAM ANALYST

Requisition No: 853085 

Agency: Agency for Health Care Administration

Working Title: 68900274 - OPS MEDICAL/HEALTH CARE PROGRAM ANALYST

 Pay Plan: Temp

Position Number: 68900274 

Salary:  $20.00 Hourly 

Posting Closing Date: 05/27/2025 

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 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 an OPS 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 Recipient and Provider Assistance (RPA). 

RPA serves as a primary point of contact for enrolled Medicaid providers, Medicaid recipients, and members of the community with questions and concerns about Medicaid.

This position is responsible for maintaining up-to-date knowledge concerning the Florida Medicaid program, including pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State Plan, and Medicaid program manuals.

Remain informed about regulations of the Agency for Health Care Administration, program manuals, and Medicaid-related activities of the agency. 

Remain informed about the operations of the Medicaid Enrollment Broker, including plan enrollment and eligibility rules.

Remain informed about the operations of the Medicaid fiscal agent and how changes impact the Enrollment Broker operations. 

Conduct an evaluation of contractor's management and operations reports for compliance.

This relates to the contractor's performance in establishing and maintaining satisfactory production schedules, levels of production, efficient processing and office procedures.

Participate in reviewing and monitoring assigned Medicaid Enrollment Broker Vendor operations, as comprehended by Agency policy and contract expectations for the purposes of providing to departmental management essential information to be used in managing enrollment broker performance within the context of the SMMC program.

Perform research and resolution activities related to Enrollment Broker Medicaid Recipient enrollment processing to determine contract compliance.

This includes, but is not limited to, research and report recipient related enrollment issues, document recipient related enrollment error trends and report to the Vendor Systems Monitoring team and assist with the monitoring or implementation of resolutions to assure proper functionality and contract compliance.  

Assist in the development, review and approval of vendor operational procedures to assure procedures comply with the contract and all amendments.     

Supports and participates in Enrollment Broker Quality Assurance monitoring.

Periodic state travel in order to conduct program monitoring 

Performs other duties as assigned.

This position will be hired at the non-negotiable rate of $20.00/hourly.

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 Other Personal Services (OPS) employees features a highly competitive set of employee benefits, including:

•              No state income tax for residents of Florida;

•              State Group Insurance coverage options (must meet eligibility requirements), including health, life, dental, vision, and other supplemental insurance options;

•              Savings & Spending Accounts;

•              401 (a) FICA Alternative Plan administered through VALIC (tax-deferred Retirement Savings Plan);

•              Participation in the Florida Deferred Compensation Plan (457b)

For a more complete list of benefits and eligibility requirements, visit www.mybenefits.myflorida.com.

What is OPS employment?

OPS employment is a temporary employer/employee relationship used for accomplishing short term or intermittent tasks. OPS employees are at-will employees and are subject to actions such as pay changes, changes to work assignments, and terminations at the discretion of the Agency head or designee. OPS employees do not serve probationary periods or become permanent in their positions because they serve at the pleasure of the Agency head.

For more information about the Bureau of Medicaid Recipient and Provider Assistance, 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

Ability to direct and coordinate the planning and implementation of operational and program reviews and program monitoring activities.

Ability to utilize problem-solving techniques.

Ability to understand and apply applicable rules, regulations, policies and procedures pertaining to a health services program.

Ability to prioritize workload.

Ability to develop various reports.

Ability to design, develop and implement research models.

Ability to manage a health services program.

Ability to assess budgetary needs.

Ability to collect and analyze financial data.

Ability to formulate policies and procedures.

Ability to plan, organize and coordinate work activities.

Ability to communicate effectively.

Ability to establish and maintain effective working relationships with others.

Ability to travel with or without accommodation.

MINIMUM QUALIFICATIONS REQUIREMENTS  

At least two years of experience in developing, evaluating and/or using data reports; for planning, workload analysis or monitoring purposes including two years of Microsoft Excel or similar software experience.

At least three years of experience explaining policies and procedures to customers with a limited understanding of the subject matter or researching and resolving customer issues and complaints.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT: AYLEN GUEVARA 850-412-4221

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.