68064262 - MEDICAL HEALTH CARE PROGRAM ANALYST

State of Florida•Tallahassee, FL

1d•$47,668 - $61,969•Onsite

About The Position

The Medical Health Care Program Analyst works in the Bureau of Medicaid Recipient Services, which serves as a primary point of contact for Medicaid recipients and community members with questions and concerns about Medicaid. The role gathers, tracks, and analyzes operational performance data to improve productivity and efficiency and requires maintaining knowledge of the Medicaid program, bureau functions, applicable Agency for Health Care Administration rules and procedures, and the Bureau Chief’s responsibilities and authority. The analyst monitors contract performance and compliance for systems that process Medicaid enrollment and Provider Network files. Duties include managing daily files for timeliness and accuracy; preparing reports, presentations, and data queries; serving as a liaison between Agency staff and other agencies on file issues or delays; and providing technical assistance to system users and health plans. The analyst researches enrollment, beneficiary, rejection, and file-processing issues and reviews system functions, documentation, and reports for accuracy. The position also coordinates and reviews contractor Client Requests, including time estimates, proposed actions, test data, and any resulting system documentation. The analyst responds to assigned correspondence, inquiries, and complaints, and remains informed about managed care issues, Medicaid-related Agency activities, and the operations of the Medicaid fiscal agent. This is an onsite position and is not eligible for remote work or telework.

Requirements

Two years of experience developing, evaluating, and/or using data reports for planning, workload analysis, or monitoring purposes.
Two years of experience using Microsoft Excel or similar software.
Three years of experience explaining policies and procedures to customers with limited understanding of the subject matter, or researching and resolving customer issues and complaints.
Knowledge of methods for compiling, organizing, and analyzing data.
Knowledge of problem-solving techniques.
Knowledge of and experience with word processing, spreadsheet, and/or database software.
Knowledge of Microsoft Office, including Outlook, Excel, and Word.
Typing skills and ability to use computer keyboard functions efficiently.
Ability to evaluate contract management operations.
Ability to coordinate Agency needs and contractor outputs.
Ability to collect, analyze, and disseminate essential information for Agency oversight of the Medicaid program.
Ability to relate effectively to clients, providers, and community agency staff.
Ability to plan, organize, and complete work assignments.
Ability to establish and maintain effective working relationships.
Ability to coordinate and prepare written and statistical reports.
Ability to travel with or without accommodation.

Responsibilities

Gather, track, and analyze operational performance data to improve operational productivity and efficiency.
Maintain knowledge of Medicaid, bureau responsibilities, applicable Agency rules and procedures, and the Bureau Chief’s responsibilities and authority.
Monitor contract performance and compliance for systems responsible for Medicaid enrollment file processing.
Prepare reports, presentations, and data query requests related to contract performance and compliance.
Monitor daily files for timeliness and accuracy and serve as the Agency liaison with staff and other agencies regarding file issues or delays.
Provide technical assistance to system users, including help with system access and technical training.
Monitor systems and research recipient enrollment, beneficiary, and rejection issues for accuracy.
Develop, review, and coordinate contractor Client Requests with Agency requestors, including time estimates and proposed actions.
Independently analyze contractor-created Client Request test data and review it with the requestor, answering questions about system logic.
Ensure documentation resulting from Client Requests is received and reviewed for accuracy and completeness.
Respond to assigned correspondence, inquiries, and complaints related to the area of expertise.
Maintain current knowledge of managed care issues, Medicaid-related Agency activities, and Medicaid fiscal agent operations.
Monitor contract performance and compliance for the system responsible for Provider Network file processing.
Provide technical assistance to health plans using the system to submit and process Provider Network files, research file processing, and review system functions, documentation, and reports for accuracy.
Coordinate Agency needs with contractor outputs and collect, analyze, and disseminate information needed to administer and oversee the Medicaid program.

Benefits

Health insurance for eligible employees, including individual and family coverage.
Free $25,000 life insurance policy, with the option to purchase additional coverage.
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 State employee.
Ability to earn up to 104 hours of sick leave annually.
Nine paid holidays and one personal holiday each year.
Career advancement opportunities.
Tuition waivers accepted by major Florida colleges and universities.
Student loan forgiveness opportunities, subject to eligibility.
Training opportunities.
Flexible Spending Accounts.
Shared Savings Program for select medical services.
Lower copays for prescription drugs.
Health and wellness discounts.