68025241 - MEDICAL/HEALTH CARE PRORGAM ANALYST
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 Recipient Services (MRS). MRS serves as a primary point of contact for Medicaid recipients and members of the community with questions and concerns about Medicaid. This position is identified as mission essential and may be required to work during disasters, including working before, during, and/or beyond normal work hours or days in the event of an emergency. Emergency duties may include working in another county or staffing location to assist other State Agencies with emergency work. This position is not a remote or telework position.
Requirements
- Two years of experience in developing, evaluating and/or using data reports; for planning, workload analysis or monitoring purposes including two years of Microsoft Excel or similar software experience.
- Three years of experience explaining policies and procedures to customers with a limited understanding of the subject matter or researching and resolving customer issues and complaints.
- Ability to travel with or without accommodations.
Nice To Haves
- Medicaid Helpline Contact Center experience.
Responsibilities
- Completing and overseeing Complaint Screening activities ensuring timely and accurate assignments.
- Coordinating with Complaint Unit, Medicaid recipients, providers, policy staff, as needed to research and resolve issues and document activities in the complaint module, per current protocols.
- Overseeing all Complaint Screening activities, including creating screener schedules, ensuring timely assignments, educating new and current complaint screeners, developing and maintaining educational materials, organizing meetings and training sessions.
- Working with Contact Center leadership to identify individual and team skills gaps and develop training to address them.
- Providing customer service to high-volume Contact Center in Miami, answering recipient and provider questions regarding Medicaid covered services and Choice Counseling regarding the Statewide Medicaid Managed Care (SMMC) programs and making referrals to the appropriate agencies.
- Researching and responding to Medicaid issues, concerns, and complaints, as well as providing technical assistance to help recipients and providers understand Medicaid coverage policy and assure that recipients receive proper care as set forth in State Statutes, rules, policies, and Code of Federal Regulations.
- Serving as the team lead for staff screening and assigning Medicaid complaint submissions and providing policy and procedural guidance to unit staff.
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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
