68055653 - MEDICAL/HEALTH CARE PROGRAM ANALYST

State of Florida•Tallahassee, FL

11d

About The Position

This is a full-time career service position, with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5:00 p.m. This Medical Health Care Program Analyst position is anticipated to be filled at a rate of $1,833.39 b/w and is non-negotiable. This position may involve travel-related activities from 1-15%. Successful completion of a criminal background investigation is a condition of employment. A good attendance record is essential for any individual in this position as the work involved occurs daily and is time sensitive. The individual in this position is expected to report to work daily and on time. The Agency for Health Care Administration is seeking to fill a Medical Health Care Program Analyst position within the Bureau of Medicaid Program Integrity (MPI). MPI is the Agency’s lead unit responsible for oversight of Medicaid fraud, waste, and abuse, and ensure compliance with applicable laws, rules, and contractual requirements. This Medical Health Care Program Analyst position will report to a supervisor in the Overpayment Recoupment Unit (Institution) within MPI for the purposes of analyzing and auditing Medicaid providers. Key responsibilities include conducting data and programmatic analyses, performing desk audits, coordinating with internal staff and peer reviewers, and collaborating with attorneys to support and defend work products throughout the judicial process. MPI seeks applicants who are able to demonstrate strong auditing or investigative, research, and organizational skills, as well as having up-to-date knowledge of the Florida Medicaid program and be able to accurately apply software programs needed to complete investigations and audits. Applicants should also possess the ability to review and comprehend applicable federal and state laws, rules, and policies related to health care and enforcement activities. This knowledge will be needed to assist MPI in appropriately conducting audits, making referrals to other entities, recovering overpayments, applying administrative sanctions, and processing final orders involving Medicaid providers. MPI offers a multitude of training opportunities for all MPI employees to enhance their professional growth. MPI is undergoing some exciting changes and the candidate will be involved in activities of a broader nature within the Agency to support the Agency’s overall mission. Benefits of Working for the State of Florida: Working for the State of Florida is more than a paycheck. We offer an excellent array of benefits, including: • 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. For a more complete list of benefits, please visit https://www.mybenefits.myflorida.com/

Requirements

Two years of professional or nonprofessional experience in a regulatory or health service setting.
An associate’s degree from an accredited college or university can substitute on a year for year basis in a related field such as: health law, health science, health services administration, business administration, public administration, sociology, criminology, criminal justice, or a substantially similar discipline.
Ability to solve problems and make decisions based on available information.
Ability to execute projects and assignments timely and accurately within a fast-paced environment.
Ability to conduct investigations, coordinate investigative activities, and accurately document the result of an investigation.
Ability to conduct fact finding research.
Ability to work independently.
Ability to communicate effectively verbally and in writing.
Ability to review and comprehend applicable federal and state laws, rules, policies, and regulations related to health care and enforcement activities.
Ability to demonstrate proficiency using Microsoft Word, Excel, Outlook, PowerPoint, SharePoint.
Ability to travel with or without accommodation.
Knowledge of the Florida Medicaid Program.
Knowledge of research or investigative principles, practices, and techniques.

Nice To Haves

Preference will be given to candidates with a program integrity related professional certification, such as: Certified Fraud Examiner; Accredited Healthcare Fraud Investigator; Certified Financial Crimes Investigator; Certified Insurance Fraud Investigator; Certified Compliance and Ethics Professional, or other relevant certification, such as: Project Management Professional.
Preference will be given to candidates with professional experience in business, data, or information analysis.

Responsibilities

conducting data and programmatic analyses
performing desk audits
coordinating with internal staff and peer reviewers
collaborating with attorneys to support and defend work products throughout the judicial process

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