What are the responsibilities and job description for the 68900064 - OPS REGULATORY ANALYST III position at State of Florida?
Requisition No: 845873
Agency: Agency for Health Care Administration
Working Title: 68900064 - OPS REGULATORY ANALYST III
Pay Plan: Temp
Position Number: 68900064
Salary: $19.90 Hourly
Posting Closing Date: 02/09/2025
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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 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 an OPS Regulatory Analyst III 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 Fiscal Agent Operations (MFAO). MFAO serves as the primary organizational unit within the Agency to provide oversight and monitoring of the Agency’s Medicaid fiscal agent; responsible for the processing of Florida Medicaid claims and multiple supporting systems; ensuring Medicaid providers are properly enrolled into the program, Medicaid recipients receive proper coverage, enrollment into managed care plans; extracting, analyzing, and/or reporting Medicaid data; and ensuring that new Agency systems are planned and procured.
This position is responsible for:
- Reviewing incoming final orders from AHCA Licensure, Medicaid Program Integrity, and the Florida Department of Health.
- Assisting Medicaid providers with access requests for the Background Screening Clearinghouse.
- Reviewing incoming rapback notices from the Background Screening Unit for potential action.
- Creating and tracking updates to the Florida Medicaid Managed Information System (FMMIS) regarding provider eligibility and contract statuses.
- Processing denials of new applications and terminations of existing providers due to compliance issues.
- Responding to outreach from external inquiries relating to provider enrollment and compliance matters.
- Providing research assistance and Medicaid enrollment/eligibility information to other state agencies and AHCA bureaus.
- Possessing and maintaining up-to-date knowledge concerning the Florida Medicaid Program, including the Florida Medicaid Management Information System (FMMIS), pertinent state and federal laws and administrative rules and codes governing state and federal healthcare programs, Medicaid provider handbooks and Medicaid provider enrollment procedures.
Also, the Incumbent shall possess outstanding organizational and formal writing skills.
A skills test may be conducted at the interview.
This position will be hired at the base salary of $19.90 hourly, 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 Medicaid Fiscal Agent 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
Excellent communication skills, written and verbal.
Ability to work well in a team environment and lead team members to produce successful outcomes.
Strong analytical, research and critical thinking skills.
Working knowledge and familiarity with Microsoft Office products.
Ability to self-motivate, operate independently, reasonably, and decisively with limited supervision.
Ability to self-manage workload by prioritization and respond to immediate needs of management.
Knowledge of state and federal health care procedures, programs and regulation.
Capacity to write and prepare system, application and user documentation in various formats including Excel.
Ability to collect, evaluate and analyze data
Ability to organize data into a logical format for presentation in reports, documents and other written material
Ability to utilize problem-solving techniques and make decisions independently
MINIMUM QUALIFICATIONS REQUIREMENTS
One year of experience in either a state regulatory setting or health care setting relating to data entry and processing or customer service.
LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS
N/A
CONTACT: CARISSA BAXTER 850-412-3440
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.
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.
Salary : $20
