Medicaid Program Integrity Analyst

State of Florida; Tampa (FL); On-site; USD 42,000 - 52,000; Full time

Benefits offered by this job

Health insurance

Life insurance

Dental, vision and supplemental ins.

State retirement options

Paid annual leave

Holidays and personal day

Job summary

State of Florida's Agency for Health Care Administration in Tampa seeks a Medical Health Care Program Analyst to conduct investigations and audits of Medicaid providers. The role involves visiting sites, identifying overpayments, and initiating necessary restrictions, with travel up to 75%.

The analyst will write comprehensive reports, make referrals, and collaborate across MPI units on projects while handling data-driven investigations, legal considerations, and timely communication.

Qualifications

• Two years of professional or nonprofessional experience in a regulatory or health service setting.
• Associate degree substitution allowed when related field is provided.
• Preference for certifications related to program integrity or compliance.

Responsibilities

• Conduct investigations and audits related to Medicaid providers.
• Visit providers and identify overpayments and enforce corrective actions.
• Write summary reports and make referrals to other entities.
• Collaborate with MPI units and lead or participate in special projects.
• Use open-source and proprietary data to support investigations and monitor case status.

Skills

Problem solving

Project management

Investigations

Fact finding

Independent work

Communication

Legal knowledge

MS Office

Travel willingness

Research skills

Medicaid knowledge

Investigation principles

Education

Associate degree

Job description

State of Florida's Agency for Health Care Administration in Tampa seeks a Medical Health Care Program Analyst to conduct investigations and audits of Medicaid providers. The role involves visiting sites, identifying overpayments, and initiating necessary restrictions, with travel up to 75%.

The analyst will write comprehensive reports, make referrals, and collaborate across MPI units on projects while handling data-driven investigations, legal considerations, and timely communication.