OPERATIONS REVIEW SPECIALIST - 64007496

State of Florida • Tallahassee, FL

2d • Onsite

About The Position

Department of Health
Division of Medical Quality Assurance
Bureau of Enforcement
Consumer Services Unit
Internal Agency Opportunity
Full-time Career Service Position
Annual Salary: $47,668.01 - $48,668.01

Applicants accepted only from Department of Health employees, (includes OPS, Career Service, SES or SMS employees).
Applicants will not be accepted from outside of the department.

Requirements

• Proficient computer skills to include Word, Excel, PowerPoint and Outlook; knowledge of computer data bases; knowledge and use of the compliance management system and licensing system used by the Agency; knowledge of laws, legal codes, court procedures and government rules & regulations; knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar; understanding written sentences and paragraphs in work related documents; communicating effectively with others verbally and in writing; talking to others to effectively convey information; ability to establish and maintain effective working relationships with others; listening to what other people are saying and asking questions as appropriate; conduct fact-finding research; knowledge of the methods of data collection and analysis; organize data into logical format for presentation in reports, documents and other written materials; knowing how to find information and identifying essential information; finding ways to structure or classify multiple pieces of information; ability to plan, organize and prioritize work assignments; ability to work independently; ability to maintain a high degree of accuracy and close attention to detail; effectively manage time; make sound judgements; ability to maintain strict confidentiality.
• Four (4) years of professional experience to include data entry, case management, reviewing or auditing documents for specific criteria; applying applicable laws, rules, regulations, policies, and procedures; researching and gathering data; preparing reports and correspondence.
• Must have a valid driver's license, satisfactorily complete a background investigation, fingerprinting, and participation in direct deposit are requirements for employment.

Nice To Haves

• Bachelor’s degree from an accredited college or university in a related field of study
• College education can substitute the experience on a year-for-year basis.

Responsibilities

• Analyzes and processes medical/allied health complaints consisting of Code 15 Reports (Hospital, Nursing Home & Assisted Living Facility), civil malpractice settlements, civil complaints, hospital disciplinary reports, internet prescribing/unlicensed storefront pharmacies and consumer complaints against Florida health care licensees to determine conformity with existing quality assurance principles and standards. The hospital, nursing home & assisted living facility complaints are complex. Data is analyzed and employee develops solutions or alternative methods of proceeding or resolving issues.
• Consults with federal, state, and local organizations on matters related to the above reports/complaints.
• Interprets and applies statutes, policies, and regulations in analyzing complex data regarding patient care and malpractice issues involving health care practitioners.
• Reviews documents and/or contacts appropriate parties to ensure compliance with applicable statutory and regulatory requirements.
• Conducts investigations when appropriate; issues subpoenas, citations, cease and desist agreements and notices of non-compliance; contacts and interviews witnesses and experts as necessary when conducting investigations; prepares investigative reports and prepares file for legal review; testifies at hearings as necessary.
• Provides technical assistance, consultative services and direction for development, implementation and evaluation of data and reports.
• Researches, prepares, and disseminates reports of a topical or statistical nature as required by management or agency officials.
• Consults with, assists, and acts as liaison between and among the professional boards, complainants, licensees, consultants, other governmental agencies, and the various sections of the agency; assists in the development of consumer education materials.
• Evaluates and interprets laws, rules, and regulations as they apply to various practice acts and related statutes and recommends changes as necessary.
• Represents the agency at board meetings, probable cause panel meetings, hearings, conferences; attends education seminars to enhance professional development and expertise.
• Assists as mediator in resolution of complaint issues.
• Assists with training in use of new forms, reports, procedures according to policy.
• Performs other duties as required.

Benefits

• Annual and Sick Leave benefits
• Nine paid holidays and one Personal Holiday each year
• State Group Insurance coverage options, including health, life, dental, vision, and other supplemental insurance options
• Retirement plan options, including employer contributions (for more information, please click www.myfrs.com)
• Flexible Spending Accounts
• Tuition waivers

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level