68900326 - OPS GOVERNMENT ANALYST II

State of Florida • Tallahassee, FL

6d • Onsite

About The Position

The Agency for Health Care Administration (AHCA) is hiring an OPS Government Analyst II in the Bureau of Medicaid Policy. The position evaluates applied behavior analysis (ABA) services documentation submitted to and produced by the Agency. It requires advanced expertise in ABA, a thorough understanding of behavioral principles, and the ability to collaborate with multidisciplinary teams to promote positive outcomes. The position is not remote or telework and pays a non-negotiable $50.00 per hour.

The Bureau of Medicaid Policy develops, coordinates, and implements Florida Medicaid policies, including federal authorities, administrative rules, coverage policies, managed care contracts, bill analyses, drug utilization review boards, preferred drug lists, supplemental rebate contracts, and KidCare/Title 21. The analyst evaluates treatment plans, behavioral assessments, client data, and provider documentation for compliance with Medicaid policy and to support effective care. The role also contributes to Agency policy, evaluation tools, processes, communications, and staff training related to ABA services.

OPS employment is a temporary, at-will employer/employee relationship used for short-term or intermittent tasks. OPS employees do not serve probationary periods or become permanent by virtue of their OPS service. Applicants must successfully complete required background screening before beginning employment.

Requirements

• Advanced knowledge of medical necessity criteria specific to ABA services.
• Knowledge of Medicaid coverage, benefit limitations, and state and federal mandates.
• Deep literacy in clinical assessment metrics to verify objective baseline data and client progress.
• Strong written and verbal communication, organizational, and problem-solving skills.
• Ability to work independently and collaboratively while maintaining positive working relationships.
• Ability to interpret graphical behavioral data and progress notes to identify plateaued progress or over-utilization.
• Ability to focus on clinical evidence, guidelines, and contractual policies over subjective peer sentiment.
• Ability to identify and clearly record documentation deficiencies.
• Ability to independently manage manual workflow tracking for missing provider data.
• Ability to manage multiple priorities effectively.
• Ability to review information for accuracy.
• Successful completion and approval of required State and National criminal history screening before beginning employment.

Nice To Haves

• Three years of direct clinical ABA experience.
• Active Board Certified Behavior Analyst (BCBA) certification in good standing with the Behavior Analyst Certification Board (BACB).

Responsibilities

• Evaluate individualized ABA treatment plan design and implementation for alignment with Medicaid service definitions and standards.
• Identify treatment plan deficits to support Medicaid policy compliance and optimize client outcomes.
• Evaluate treatment plan alignment with behavioral assessments and data.
• Evaluate behavioral assessments and analyze client data to identify needs and develop effective intervention strategies.
• Ensure evaluation and intervention activities comply with Medicaid coverage policies, medical necessity standards, and documentation requirements.
• Collaborate with Agency staff to develop policy, evaluation tools and processes, and communications regarding ABA services.
• Provide Agency staff training on ABA principles and practices.
• Participate in team meetings.
• Evaluate provider documentation of client progress.
• Maintain Medicaid-related records in accordance with Agency and HIPAA guidelines and applicable regulatory and ethical standards.
• Research current evidence-based or best practices related to ABA services.
• Ensure practices are consistent with Medicaid policy, regulatory standards, certifying-entity ethical guidelines, and relevant federal and state statutes.
• Independently manage workflow tracking for missing provider data.
• Review information for accuracy and clearly record documentation deficiencies.

Benefits

• No state income tax for Florida residents.
• State Group Insurance coverage options, subject to eligibility requirements, including health, life, dental, vision, and supplemental insurance.
• Savings and Spending Accounts.
• 401(a) FICA Alternative Plan administered through VALIC (tax-deferred retirement savings plan).
• Participation in the Florida Deferred Compensation Plan (457b).

What This Job Offers

• Career Level: Mid Level
• Education Level: No Education Listed