MEDICAL/HEALTH CARE PROGRAM ANALYST

68064836 - MEDICAL / HEALTH CARE PROGRAM ANALYSTDate : Jan 7, 2025The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website () .Requisition No : 837768Agency : Agency for Health Care AdministrationWorking Title : 68064836 - MEDICAL / HEALTH CARE PROGRAM ANALYSTPay Plan : Career ServicePosition Number : 68064836Salary : $1,794.92 BiweeklyPosting Closing Date : 01 / 19 / 2025Total Compensation Estimator Tool ()Agency Overview : 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 QUALITYEmphasizing quality in all that we do to improve health outcomes, always putting the individual first.TRANSPARENTSupporting initiatives that promote transparency and empower consumers in making well informed healthcare decisions.COST-EFFECTIVELeveraging 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.The bureau’s primary responsibility is ensuring that the managed care plans meet Medicaid contractual requirements, including the timely provision of medically needed services and provider payment for such services.This position is responsible for reviewing, analyzing, and monitoring managed care plan activities and services.This work consists of conducting studies and evaluations, developing reports, 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 lead contact in targeted monitoring activities working closely with the Agency's contract managers responsible for the Medicaid managed care plan contract(s).The incumbent in this position maintains up-to-date knowledge concerning the Florida Medicaid program by researching and analyzing pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State Plan, federal managed care waivers, and Medicaid policies.The incumbent remains informed about regulations of the Agency for Health Care Administration, managed care contracts, as well as Medicaid systems and technology, and Medicaid-related activities of the Agency.The incumbent maintains knowledge about Agency operating procedures and processes.The incumbent conducts strategic 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 contracts.The incumbent plans, organizes and coordinates targeted program monitoring activities for Medicaid managed care plans including oversight analysis to identify managed care plan compliance issues and problems.The incumbent provides guidance and counsel to Plan Management leadership and their staff by analyzing results and findings and developing compliance actions as prescribed in the managed care contract (e.g., corrective action plans, sanctions, liquidated damages, etc.) and completing follow-up investigation to ensure compliance with the managed care plan contract and Medicaid policies and proceduresThis position would be hired at the base rate of $1,794.92 bi-weekly and is non-negotiable.This position is not a remote or telework position; it will have to report to a Field Office or the Headquarters in Tallahassee.Benefits of Working for the State of Florida : Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including :

• State Group Insurance Coverage Options, including health, life, dental, vision, and other supplemental insurance options;
• Flexible Spending Accounts;
• State of Florida retirement options, including employer contributions;
• Generous annual and sick leave benefits;
• 9 paid holidays a year and 1 Personal Holiday each year;
• Career advancement opportunities;
• Tuition waiver for courses offered by Florida’s nationally ranked State University System;
• Training and professional development opportunities;
• And more!For more information about the Bureau of Plan Management Operations, please visit our website at 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
• Knowledge of the Medicaid Program and Managed Care.
• Knowledge of the methods of data collection and analysis.
• Ability to develop tracking systems, maintain accurate information within tracking systems, and coordinate the gathering of information from various sources.
• Ability to organize data into logical formats for presentation in reports, documents and other written materials.
• Ability to conduct fact-finding research.
• Ability to work independently.
• Ability to understand and apply applicable rules, regulations, policies and procedures relating to plan management activities.
• Ability to plan, organize, coordinate and complete work assignments.
• Ability to communicate effectively.
• Ability to establish and maintain effective working relationships with others.
• Ability to travel with or without accommodations.
• Ability to work with Microsoft Suite; proficient in Microsoft Word, Excel, Outlook and Microsoft Edge.MINIMUM QUALIFICATIONS REQUIREMENTS
• At least one (1) year of professional experience working with contract or program related activities (e.g. compliance reviews, providing technical assistance).
• At least one (1) year of professional work experience in auditing, investigating, or monitoring a program or service.Preference will be given to the candidates who have :
• At least one (1) year of experience analyzing data and reporting findings in regards to a program or service.
• Work experience with using Microsoft Excel to create tables and communicate data
• Work experience with using Microsoft Word to create tables or summariesLICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTSN / ACONTACT : BRITTANY NIX 850-412-4261BACKGROUND SCREENINGIt 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.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. 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 clickinghere () . All documentation is due by the close of the vacancy announcement.Location : TALLAHASSEE, FL, US, 32308Nearest Major Market : Tallahassee

Salary : $1,795