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MEDICAL/HEALTH CARE PROG ANALYST - 68024323

Date: Jul 13, 2017

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: 15336 

Agency: Agency for Health Care Administration

Working Title: MEDICAL/HEALTH CARE PROG ANALYST - 68024323

Position Number: 68024323 

Salary:  $1,574.93 BI WEEKLY 

Posting Closing Date: 07/26/2017 

This position works in a professional capacity analyzing, developing, implementing and/or monitoring contracted medical assistance services within the Bureau of Plan Management Operations. This work consists of conducting studies and evaluations, 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 a Specialty Plan Contract Manager and the lead point of contact for assigned Medicaid contract(s).

The incumbent in this position maintains up-to-date knowledge concerning the Florida Medicaid program, including pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State Plan, managed care waivers, and Medicaid program handbooks and manuals. The incumbent remains informed about regulations of the Agency for Health Care Administration (Agency), managed care contracts, as well as Medicaid systems and technology, and Medicaid-related activities of the Agency. The incumbent remains informed about Medicare and other federal and state health care related programs, including other state and national Medicaid related research and demonstration projects, medical assistance and health care program innovations for special populations, and alternative financing and service delivery system models. The incumbent maintains knowledge about Agency operating procedures and processes.  The incumbent remains informed about the operations of the Medicaid fiscal agent, including Medicaid claims processing, billing procedures, reimbursement methodologies, and provider enrollment.

The incumbent conducts strategic planning activities for Medicaid managed care programs in order to assist in the development of program goals, objectives and priorities of the Medicaid managed care programs and contracted Medicaid medical assistance services. The incumbent conducts 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 contracted Medicaid medical assistance services.

The incumbent acts as agency contract manager for their assigned Statewide Medicaid Managed Care Specialty Plan Contract, which shall include but may not be limited to maintaining active Agency and state of Florida contract manager certification, adhering to established Agency procurement policies and procedures, participating in the competitive and non-competitive procurement and development of assigned contracts, overseeing the day-to-day administrative, programmatic, and financial operations of assigned contracts, maintaining appropriate and up-to-date contract files, and serving as liaison with assigned contract vendor(s). The incumbent plans, organizes and coordinates the program monitoring activities for Medicaid managed care plans to ensure compliance with federal regulations, statutes, administrative rules, Florida Medicaid State Plan, contract compliance, and Medicaid policies and procedures, including performing contract monitoring of vendor performance at least annually. The incumbent shall analyze the results and findings and develop compliance actions as prescribed in the contract (e.g. corrective action plans, sanctions, liquidated damages, etc.)

The incumbent conducts program training and provides technical assistance related to Medicaid managed care programs, included contracted Medicaid medical assistance services, 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 leads and coordinates meetings within the Agency, between the Agency and other state agencies, with contacts from the assigned Medicaid contract(s), and with other organizations for the purpose of presenting and evaluating Medicaid programs and contracted Medicaid medical assistance services. The incumbent participates in meetings, conferences and workshops on federal and state health care related programs and managed care programs. The incumbent prepares and delivers speeches and presents programs to provider groups, provider associations, and other local, state and national associations and organizations. The incumbent represents Medicaid on health care related committees, task forces, and special projects as assigned.

The incumbent in this position conducts program evaluation activities in order to evaluate the efficiency and effectiveness of Medicaid managed care programs and contracted Medicaid managed medical assistance services; and assesses the achievement of goals, objectives and priorities of the Medicaid program related to the managed care projects.

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.

KNOWLEDGE, SKILLS, AND ABILITIES:

Additional requirements for this position:
• Ability to communicate effectively, verbally and in writing.
• Ability to work cooperatively as a member of the team.
• Ability to accurately collect, analyze and evaluate data quickly, develop reports and make recommendations.
• Ability to understand and apply applicable statutes, rules, regulations, policies and procedures.
• Ability to determine work priorities, assign and ensure proper completion of work assignments in a timely manner.
• Knowledge of methods necessary for efficient compilation, organization and analyzation of data.
• Knowledge of health care facilities, operations, and management.
• Knowledge of, and experience with, word processing, spreadsheet and/or database software.
• Knowledge of state procurement laws and contract management policies/procedures..
• Knowledge of word processing, spreadsheet, and/or database software.
• Ability to apply state procurement laws and contract management policies/procedures.

 

MINIMUM QUALIFCATIONS:

Must have at least one (1) year of previous work experience as a contract manager as well as at least one (1) year of previous work experience with Medicaid Programs.

PREFERENCE WILL BE GIVEN TO CANDIDATES WITH KNOWLEDGE OF THE MEDICAID PROGRAM AND/OR CONTRACT MANAGEMENT.


CONTACT PERSON: LISA GILL (850) 412-4042

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