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OPS MEDICAL/HEALTH CARE PROGRAM ANALYST - 68900289

Date: Nov 3, 2017

Location: TALLAHASSEE, FL, US, 32308

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Requisition No: 23481 

Agency: Agency for Health Care Administration

Working Title: OPS MEDICAL/HEALTH CARE PROGRAM ANALYST - 68900289

Position Number: 68900289 

Salary:  $19.69 HOURLY 

Posting Closing Date: 11/09/2017 

This is an exciting opportunity within the Agency’s Bureau of Medicaid Program Integrity (MPI).  MPI serves as the primary organizational unit within the Agency for the purposes of prevention, detection, and recoupment/enforcement related to Medicaid program oversight, as well as the lead unit for compliance with contractual and statutory requirements related to fraud and abuse activities.  MPI has several sub-units that serve the overall bureau mission.  Among those sub-units are teams working toward the detection of fraud, abuse, and waste in the Medicaid program (detection units), teams working to strategize the use of bureau resources to maximize fraud prevention efforts (prevention units), teams involved with the oversight and investigation of Medicaid managed care organizations (managed care units), and teams involved with the auditing and recovery of overpayments related to specific Medicaid providers (case management units).  

 

MPI seeks applicants who are able to demonstrate strong auditing or investigative, research, and organizational skills, as well as have up-to-date knowledge of the Florida Medicaid program and be able to accurately apply software programs needed to complete investigations and audits. Applicants should also possess the ability to review and comprehend applicable federal and state laws, rules, and policies related to health care and enforcement activities. This knowledge will be needed to assist MPI in appropriately conducting investigations, making referrals to other entities, recovering overpayments, applying administrative sanctions, and performing compliance reviews.

 

This OPS Medical Healthcare Program Analyst position will report to a Program Administrator supervising within the Managed Care unit and will support the detection and prevention (of fraud and abuse) efforts within the Bureau of Medicaid Program Integrity (MPI). The selected candidate may also be responsible for making recommendations for changes to the Medicaid managed care contract, related to fraud and abuse substantive language. The unit is seeking a candidate with a broad array of knowledge and experience, and specifically knowledge related to fraud prevention and detection programs, compliance assessment and the investigative process. Included in the expected assigned functions are activities such as data and programmatic analysis, completion of desk reviews, coordination with other staff, and onsite review activities. This position is anticipated to be filled at the rate of $19.69 per hour, budgeted for a 40-hour workweek.

 

MPI offers a multitude of training opportunities for all MPI employees to enhance their professional growth.  MPI is undergoing some exciting changes and the candidate will be involved in activities of a broader nature within the Agency to support the Agency’s overall mission.

 

This position requires travel.

 

KNOWLEDGE, SKILLS, AND ABILITIES

  • Ability to demonstrate strong investigative, research, and organizational skills.
  • Ability to accurately apply software programs needed to complete investigations. 
  • Ability to utilize data analysis techniques.
  • Ability to conduct investigations, coordinate investigative activities, and accurately document the results of an investigation. 
  • Ability to review and comprehend applicable federal and state laws, rules, and policies related to health care and enforcement activities.
  • Ability and able to travel with or without accommodations.

 

MINIMUM QUALIFICATION REQUIREMENTS

  • Have at least three years of investigative, health care, or Medicaid experience.
  • A bachelor's degree from an accredited college or university is preferred. 
  • Preference will be given to candidates with a related degree from an accredited college or university, such as: health law, health science, health services administration, business administration, public administration, sociology, criminology, or criminal justice.
  • Experience as described above can substitute on a year-for-year basis for the preferred college education.

 

CONTACT: SANDY KING (850) 412-4600

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