68039490 - Chief of Medicaid Program Integrity-Ahca

DGS Office of External Affairs; Tallahassee (FL); On-site; USD 110,000 - 150,000; Full time

Job summary

The DGS Office of External Affairs in Tallahassee seeks a Chief of Medicaid Program Integrity to lead AHCA's comprehensive strategy to prevent, detect, and investigate fraud, abuse, waste, and improper payments in Florida's Medicaid program. You will direct audits, investigations, data analytics, and compliance while supervising a diverse team.

The ideal candidate will have extensive knowledge of Florida Medicaid statutes and experience directing audits and compliance activities in health care

Qualifications

• Extensive knowledge of Florida Medicaid program statutes, regulations, and billing procedures.
• Experience directing audits, investigations, and compliance activities in health care or government programs.
• Demonstrated strategic leadership and ability to supervise diverse professional staff.
• Strong communication and stakeholder collaboration skills with federal, state, and law enforcement partners.
• Experience in fraud prevention, program integrity, and risk-based operational frameworks.

Responsibilities

• Lead the Agency for Health Care Administration's comprehensive program integrity strategy to prevent, detect, and investigate fraud, abuse, waste, and improper payments in Florida's Medicaid program.
• Direct audits, investigations, data analytics, managed care oversight, and compliance activities while supervising a diverse team of professionals.
• Collaborate with state and federal partners and manage budget and policy development.

Skills

Medicaid policy knowledge

Auditing & investigations

Data analytics

Stakeholder collaboration

Leadership & supervision

Job description

The Chief of Medicaid Program Integrity leads the Agency for Health Care Administration's comprehensive program integrity strategy to prevent, detect, and investigate fraud, abuse, waste, and improper payments in Florida's Medicaid program. The incumbent directs audits, investigations, data analytics, managed care oversight, and compliance activities while supervising a diverse team of health care, financial, and investigative professionals. This position requires strategic leadership, collaboration with state and federal partners, and responsibility for budget management and policy development.

Key qualifications:

• Extensive knowledge of Florida Medicaid program statutes, regulations, and billing procedures
• Experience directing audits, investigations, and compliance activities in health care or government programs
• Demonstrated strategic leadership and ability to supervise diverse professional staff
• Strong communication and stakeholder collaboration skills with federal, state, and law enforcement partners
• Experience in fraud prevention, program integrity, and risk-based operational frameworks