68064828 - medical / health care program analyst

3 weeks ago


Tallahassee, Florida, United States State Of Florida Full time

Requisition No:

Agency:
Agency for Health Care Administration

Working Title:
# - MEDICAL/HEALTH CARE PROGRAM ANALYST

Pay Plan:
Career Service

Position Number:
#

Salary:
$1, $1,855.91 biweekly

Posting Closing Date: 05/05/2024

Total 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.

Current Agency initiatives include implementing Florida's groundbreaking Canadian Prescription Drug Importation Program, overhauling Florida's healthcare technological ecosystem, and increasing insight in the cost of health care services.

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 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 a 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 Policy.

Medicaid Policy is responsible for the development, coordination, and implementation of Florida Medicaid program policies, including:
all Medicaid federal authorities (e.g. the Florida State Plan, 1115 waivers and home and community-based waivers), administrative rules, coverage policies, managed care plan contracts, bill analyses, drug utilization review boards, preferred drug lists, supplemental rebate contracts, and KidCare/Title 21.

This position is responsible for researching, developing, implementing, evaluating, and maintaining policies under the Florida Medicaid program. Interagency agreements are to be maintained, updated, and worked on across multiple agencies.

The position is responsible for maintaining accuracy, researching areas of the contract that need further vetting and working with personnel across multiple agencies.

Attention to detail and making sure of the accuracy of these contracts is important to success in this position. This position is also responsible for processing invoices and maintaining proper documentation/logs.

Research

The incumbent shall:

  • Maintain uptodate knowledge concerning all aspects of the Florida Medicaid program, including federal regulations, state statutes, administrative rules, and the Florida Medicaid State Plan.
  • Maintain uptodate knowledge of health care and relevant industry trends that may have an impact on Florida Medicaid or may inform policy development activities.
  • Remain informed about the operations of the Medicaid fiscal agent, including Medicaid claims process, billing procedures, reimbursement methodologies, encounter submissions, and provider enrollment.
  • Remain informed about Medicare policies, national Medicaidrelated research and demonstration projects, Medicaid medical assistance program innovations for general and special populations, and alternative financing and service delivery systems models.
  • Conduct research on assigned topics, including, but not limited to performing a review of peerreviewed research articles, federal and state laws, other reliable sources of evidence, the Medicaid State Plan, Agency communications, State Medicaid Director Letters, and vendor contracts.
Program Planning and Analysis

The incumbent shall:

  • Analyze health care/program related information (including alternative financing and reimbursement strategies) in order to determine the effect on the Florida Medicaid program and compliance with federal and state laws.
  • Assist in the analysis and development of programmatic and fiscal impact statements based on proposed federal/state program or policy changes.
  • Prepare reports of research findings, including synthesizing complex and/or large amounts of information into a useful format and presentation.
  • Assist in the development of legislative budget requests and program proposals.
  • Assist in the development of grant proposals.
  • Assist in the completion of legislative reports, including collection of necessary data elements.
  • Assist in the development and implementation of program designs, projects, and/or plans in order to meet bureau goals/priorities.
Policy Development

The incumbent shall:

  • Develop and maintain program policies and procedures under the Florida Medicaid program to ensure that programs operate in accordance with the goals and objectives of the Agency, state and federal laws, rules, regulations, and guidelines.
  • Assist in the development of policy language for: the Medicaid managed care report guide, Medicaid contracts and amendments; Dear Managed Care Plan letters, contract interpretations, policy transmittals, and provider alerts.
  • Track and monitor the routing and approval of all policy documents to ensure timely completion and adherence to Agency established deadlines.
Communication

The incumbent shall:

  • Assist in the development of training and providing technical assistance to ensure consistency in service/program operation and conformity with goals and objectives of the Agency, state and federal laws, rules, regulations, and guidelines.
  • Develop, coordinate, and implement statewide program training plans.
  • Identify and document training needs.
  • Design and evaluate training programs and materials.
  • Conduct statewide and local trainings, as required.
  • Provide technical assistance regarding service/program policies and procedures.
  • Provide consultation through the accurate presentation of data and other service/program information.
  • Participate on behalf of the Agency in local, state, or national meetings, conferences, workshops, and seminars related to the Florida Medicaid program.
  • Prepare presentations materials, as assigned.
Contract Management

The incumbent shall:

  • Perform contract management activities in accordance with goals and objectives of the Agency and state and federal laws, rules, regulations, and guidelines.
  • Develop and execute provider contracts addressing standard contract documents, services to be provided, manner of service provision, method of payment, and special provisions.
  • Process, inspect, review, and approve deliverables, and invoices for payment.
  • Track and monitor provider expenditures.
  • Maintain appropriate contract files and records.
  • Carry out other necessary contract management activities.
This position may require travel.


All applicants must ensure that all employment and detailed information about work experience is listed on your applicant profile and/or resumé (including dates of service, reason for leaving, military service, self-employment, job-related volunteer work, internships, etc.) and that gaps in employment are explained.

Applicants who do not provide all the information necessary to meet the minimum requirements will not be considered for this position.


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 Policy, our website at


Join us at the Agency for Health Care Administration in fulfilling our mission to provide "Better Health Care for all Floridians.

"

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  • Knowledge of basic management principles and practices.
  • Ability to collect, evaluate and analyze data to develop alternative recommendations, solve problems, document workflow and other activities relating to the improvement of management practices.
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