68021778 - GOVERNMENT OPERATIONS CONSULTANT III

State of Florida•Miami, FL

2d•$50,585 - $65,760•Onsite

About The Position

This is an exciting opportunity to help shape the quality of health care in Florida. We are seeking to hire Government Operations Consultant 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 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 development of policy language for Statewide Medicaid Managed Care (SMMC) Plan Communications (i.e., Dear Managed Care Plan letters, contract interpretations, policy transmittals, and provider alerts); processing Medicaid Managed Care Plan Report Guide revisions; and updating and/or requesting updates to SMMC webpages as directed. The incumbent will track and monitor the routing and approval of all the policy documents to ensure timely completion and adherence to Agency established deadlines. Examples of tasks the incumbent may be asked to do include, but are not limited to: Interpret policy documents and develop written guidance to SMMC plans. Create contract language. Simplify policies to create program highlight documents.

Requirements

Acquire and maintain up-to-date knowledge of the Florida Medicaid program, including pertinent Federal laws and regulations, state statutes and rules.
Utilize fine-tuned research skills to provide consultative information to internal and external stakeholders.
Execute projects, assignments, and policy updates timely and accurately within a fast-paced environment.
Provide consultation and expert advice to leadership using logic and analysis to identify the strengths and weaknesses of different approaches.
Communicate effectively both verbally and in writing.
Establish and maintain effective working relationships with others.
Function both independently and in a team environment.
Be flexible to function and succeed both with and without extensive direction.
Determine work priorities and ensure proper completion of work assignments.
Communicate, correspond, and provide training/presentations to both internal and external inquirers.
Two years of experience using Microsoft Office Suites.
Two years of experience developing State or health care related policies.
Two years of experience developing and writing high-level communications/documents for external distribution and/or public webpage posting.
Must successfully complete training in contract management and become a certified contract manager within six months of hire in accordance with section 287.057(15)(c), F.S.

Nice To Haves

A four (4) year (bachelor's) degree from an accredited college or university is preferred.
Hold a current Florida Certified Contract Manager (FCCM) certification.
Professional writing experience (e.g., policy development, grant writing/submissions, rule promulgation, research publications, white papers, etc.).

Responsibilities

Interpret policy documents and develop written guidance to SMMC plans.
Create contract language.
Simplify policies to create program highlight documents.
Maintain up-to-date knowledge concerning all aspects of the Florida Medicaid program, including federal regulations, state statutes, administrative rules, and the Florida Medicaid State Plan.
Maintain up-to-date 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 Medicaid-related 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 peer-reviewed research articles, federal and state laws, other reliable sources of evidence, the Medicaid State Plan, Agency communications, State Medicaid Director Letters, and vendor contracts.
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.
Participate, and contribute to, formal and informal project teams, as assigned.
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.
Submit approved policy documents for publication on the appropriate Agency webpages, as required.
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.
Identify and document training needs.
Design and evaluate training programs and materials.
Conduct statewide and local training, as required.
Provide technical assistance regarding service/program policies and procedures to both internal and external stakeholders.
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 presentation materials, as assigned.
Receive and route for approval, requests for contract amendments.
Develop and route for execution, standard contract documents and amendments.
Track and monitor progression of contracts and amendments through Agency's formal contract tracking system.
Carry out other necessary contract development activities.

Benefits

Health insurance (i.e., individual and family coverage) to eligible employees
Life insurance; $25,000 policy is free plus option to purchase additional life insurance
Dental, vision and supplemental insurance
State of Florida retirement options, including employer contributions
Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida
Ability to earn up to 104 hours of sick leave annually
Nine paid holidays and 1 personal holiday each year
Opportunities for career advancement
Tuition waivers (accepted by major Florida Colleges/universities)
Student loan forgiveness opportunities (eligibility required)
Training opportunities
Flexible Spending Accounts
Shared Savings Program for select medical services
Lower copays for prescription drugs
Health and Wellness discounts