68900296 - OPS MEDICAL/HEALTH CARE PROGRAM ANALYST

State of Florida

1d • Onsite

About The Position

This is an exciting opportunity to help shape the quality of health care in Florida. We are seeking to hire an OPS 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 is a professional position in the Medicaid Contact Center, within the Bureau for Recipient and Provider Assistance (RPA) within the Division of Medicaid, Agency for Health Care Administration (Agency). The incumbent in this position is responsible for the development, coordination, and delivery of training to contact center staff. This position is responsible for This position handles priority assignments, special projects, data analysis and report development as well as providing technical assistance to help recipients and providers understand Medicaid coverage policy as set forth in State Statutes, rules, policies and Code of Federal Regulations. Develops, plans and evaluates data analysis for the Statewide Contact Center. This includes, but are not limited to current trends, Performance Measures, Annual Monitoring Plan and corrective actions. Produces daily, weekly and monthly production and performance reports. Develops, plans and implements various special projects as requested and necessary. Serves as the designated Contact Center SharePoint Administrator. When needed and/or for escalated calls, performs duties of contact center staff (including the Choice Counseling function) by providing enrollees and potential enrollees with accurate unbiased information; and s/he will complete the appropriate actions in the correct system. The incumbent participates as a member of the Escalation Team, handles calls, completes assigned tasks, special projects and initiatives, as assigned. The incumbent may also be called upon to make assignments to other team members. Researches and responds to Legislative Assignments, CorrFlow, and other priority issues, as assigned. Contacts the constituent to obtain information, as needed. Provides updates on actions taken to resolve the issue while maintaining communication with the constituent throughout the process. The incumbent provides support by representing the Agency on local Government and Community partnerships, Medicaid overview presentations, secret shopper events, transportation boards, community alliances, interagency agreement teams, local planning groups and HIV planning councils as assigned by the FOM. Maintains up to date knowledge concerning the Florida Medicaid Program; pertinent federal laws and regulations, state statutes and rules; the Florida Medicaid State Plan and its amendment processes; Medicaid Managed Care Waivers; and Medicaid program manuals. Remains informed about Choice Counseling procedures, including the For Cause process. Remains informed about the operations of the Medicaid fiscal agent. Remains informed about Medicare, Medicaid, and related programs, research and demonstration projects, innovations for special populations, alternative financing and service delivery systems models, etc. Maintains knowledge about the Medicaid State Plan, waivers, regulations, and processes. Participates in Agency training opportunities and engages in self-education utilizing available resources. Knows how to search for pertinent federal laws and regulations, applicable state statutes and Medicaid rules, as needed. Remains knowledgeable about Statewide Medicaid Managed Care (SMMC) contract provisions and amendments, SMMC talking points and guidance statements, SMMC plan subcontractors and TPAs, and information shared via SMMC all-plan communications distributed by the Agency. Works with the Field office Manager (FOM) and Contact Center leadership to address any Technical Assistance and troubleshooting measures with the Contact Center agents. Technical Assistance will range from audio issues, network connectivity issues, system issues (including but not limited to HealthTrack, FMMIS, Outlook, Genesys, SharePoint and Teams). Serves as a backup for other Medical/Health Care Program Analysts in the Medicaid Contact Center and their duties. Performs other duties as assigned. 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. This position is not a remote or telework position. This position will be filled at $21.00 hourly and is non-negotiable.

Requirements

• Two years of experience providing a professional level of customer service in a fast-paced consumer centric environment.
• 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.

Nice To Haves

• Moderate to extensive experience and abilities using different computer programs such as Excel, Outlook, and Word, etc., including quick and accurate typing/keyboarding skills.
• Six months experience in Project Management.

Responsibilities

• Development, coordination, and delivery of training to contact center staff.
• Handles priority assignments, special projects, data analysis and report development.
• Provides technical assistance to help recipients and providers understand Medicaid coverage policy.
• Develops, plans and evaluates data analysis for the Statewide Contact Center, including current trends, Performance Measures, Annual Monitoring Plan and corrective actions.
• Produces daily, weekly and monthly production and performance reports.
• Develops, plans and implements various special projects as requested and necessary.
• Serves as the designated Contact Center SharePoint Administrator.
• Performs duties of contact center staff (including the Choice Counseling function) by providing enrollees and potential enrollees with accurate unbiased information and completing appropriate actions in the correct system.
• Participates as a member of the Escalation Team, handles calls, completes assigned tasks, special projects and initiatives.
• May make assignments to other team members.
• Researches and responds to Legislative Assignments, CorrFlow, and other priority issues.
• Contacts the constituent to obtain information, as needed.
• Provides updates on actions taken to resolve the issue while maintaining communication with the constituent throughout the process.
• Provides support by representing the Agency on local Government and Community partnerships, Medicaid overview presentations, secret shopper events, transportation boards, community alliances, interagency agreement teams, local planning groups and HIV planning councils as assigned by the FOM.
• Maintains up to date knowledge concerning the Florida Medicaid Program, pertinent federal laws and regulations, state statutes and rules, the Florida Medicaid State Plan and its amendment processes, Medicaid Managed Care Waivers, and Medicaid program manuals.
• Remains informed about Choice Counseling procedures, including the For Cause process.
• Remains informed about the operations of the Medicaid fiscal agent.
• Remains informed about Medicare, Medicaid, and related programs, research and demonstration projects, innovations for special populations, alternative financing and service delivery systems models, etc.
• Maintains knowledge about the Medicaid State Plan, waivers, regulations, and processes.
• Participates in Agency training opportunities and engages in self-education utilizing available resources.
• Knows how to search for pertinent federal laws and regulations, applicable state statutes and Medicaid rules, as needed.
• Remains knowledgeable about Statewide Medicaid Managed Care (SMMC) contract provisions and amendments, SMMC talking points and guidance statements, SMMC plan subcontractors and TPAs, and information shared via SMMC all-plan communications distributed by the Agency.
• Works with the Field office Manager (FOM) and Contact Center leadership to address any Technical Assistance and troubleshooting measures with the Contact Center agents.
• Serves as a backup for other Medical/Health Care Program Analysts in the Medicaid Contact Center and their duties.
• Performs other duties as assigned.

Benefits

• No state income tax for residents of Florida
• State Group Insurance coverage options (must meet eligibility requirements), including health, life, dental, vision, and other supplemental insurance options
• Savings & Spending Accounts
• 401 (a) FICA Alternative Plan administered through VALIC (tax deferred Retirement Savings Plan)
• Participation in the Florida Deferred Compensation Plan (457b)

What This Job Offers

• Career Level: Mid Level
• Education Level: No Education Listed