68064974 - MEDICAL/HEALTH CARE PROGRAM ANALYST

State of Florida•Tallahassee, FL

3d•Onsite

About The Position

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. Research The incumbent shall: - 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. 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. 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 information necessary to meet the minimum requirements will not be considered for this position. This position is not a remote or telework position. 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.

Requirements

One year of experience developing health care related policies.
One year of technical writing experience.
One year of experience managing complex assignments.
Ability to direct and coordinate the planning and implementation of operational and program reviews and program monitoring activities.
Ability to utilize problem-solving techniques.
Ability to understand and apply applicable rules, regulations, policies, and procedures pertaining to a health services program.
Ability to prioritize workload.
Ability to develop various reports.
Ability to design, develop, and implement research models.
Ability to manage a health services program.
Ability to assess budgetary needs.
Ability to collect and analyze financial data.
Ability to formulate policies and procedures.
Ability to plan, organize and coordinate work activities.
Ability to communicate effectively.
Ability to establish and maintain effective working relationships with others.
Ability to travel with or without accommodations.

Nice To Haves

Preference will be given to applicants that have a bachelor's degree from an accredited college or university.
Preference will be given to applicants that have two years of professional experience in program planning, research, or evaluation.

Responsibilities

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.
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.
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.

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