68025865 - MEDICAL/HEALTH CARE PROGRAM ANALYST

Florida; Tallahassee (FL); On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Health insurance

Life insurance

Dental & vision

Retirement options

Paid time off

Holidays

Career advancement

Tuition waivers

Student loan forgiveness

Job summary

The Agency for Health Care Administration (AHCA) seeks a Medical Health Care Program Analyst in Tallahassee to enhance Medicaid managed care program performance. You will analyze policies, assist contract managers, and monitor compliance with D-SNP and related services in a fast-paced, team environment.

Located in the PMO bureau, you will support statewide managed care oversight and ensure timely delivery of medically necessary services, with opportunities for growth within Florida’s health

Qualifications

• 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 work load.
• 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 accommodations.

Responsibilities

• Provide support to D-SNP contract managers within the Bureau of Plan Management Operations.
• Review administrative policies, procedures, guidelines and directives impacting contract compliance.
• Provide technical assistance and support.
• Analyze, develop, implement and/or monitor contracted Medicare and Medicaid services.

Job description

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68025865 - MEDICAL/HEALTH CARE PROGRAM ANALYST

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

Requisition No:887101

Agency: Agency for Health Care Administration

Working Title: 68025865 - MEDICAL/HEALTH CARE PROGRAM ANALYST

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 the 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 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 and Dual Eligible Special Needs (D-SNP) program.

The bureau’s primary responsibility is ensuring that the managed care plans meet contractual requirements, including the timely provision of medically needed services and provider payment for such services.

This position is responsible for providing support to the D-SNP contract managers within the Bureau of Plan Management Operations, including duties such as analyzing, developing, implementing and/or monitoring contracted Medicare and Medicaid services.

This work consists of reviewing administrative policies, procedures, guidelines and related directives impacting D-SNP contract compliance, and providing technical assistance and support.

This position is not a remote or telework position.

Benefits of Working for the State of Florida:

• Health insurance (i.e., individual and family coverage) to eligible employees
• Life insurance; $25,000 policy is free plus option to purchase additional life insurance
• Dental, vision and supplemental insurance
• State of Florida retirement options, including employer contributions
• Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida
• Ability to earn up to 104 hours of sick leave annually
• Nine paid holidays and 1 personal holiday each year
• Opportunities for career advancement
• Tuition waivers (accepted by major Florida Colleges/universities)
• Student loan forgiveness opportunities (eligibility required)
• Shared Savings Program for select medical services

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

• 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 work load.
• 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 our without accommodations.

MINIMUM QUALIFICATIONS REQUIREMENTS

• One (1) year of experience working with contract or program related activities (e.g. compliance reviews, providing technical assistance).
• One (1) year experience analyzing data.
• Experience working with managed care plans is preferred.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT

NEIRE BRAYNEN 850-412-4045

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.

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. Certain service members may be eligible to receive waivers for postsecondary educational requirements. 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.

Location

TALLAHASSEE, FL, US, 32308 TALLAHASSEE, FL, US, 32301 TALLAHASSEE, FL, US, 32302 TALLAHASSEE, FL, US, 32303 TALLAHASSEE, FL, US, 32304 TALLAHASSEE, FL, US, 32305 TALLAHASSEE, FL, US, 32307 TALLAHASSEE, FL, US, 32309 TALLAHASSEE, FL, US, 32310 TALLAHASSEE, FL, US, 32311 TALLAHASSEE, FL, US, 32312 TALLAHASSEE, FL, US, 32316 TALLAHASSEE, FL, US, 32317 TALLAHASSEE, FL, US, 32399

For assistance, call the People First Service Center at [phone] Monday - Friday, 8:00 a.m. to 6:00 p.m., Eastern time. Pursuant to Florida Law, 110.211 F. S., the State of Florida is an EEO employer.