68900274 - OPS MEDICAL/HEALTH CARE PROGRAM ANALYST
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 position is located in the Bureau of Medicaid Recipient and Provider Assistance (RPA). RPA serves as a primary point of contact for enrolled Medicaid providers, Medicaid recipients, and members of the community with questions and concerns about Medicaid. This position is responsible for maintaining up-to-date knowledge concerning the Florida Medicaid program, including pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State Plan, and Medicaid program manuals. Remain informed about regulations of the Agency for Health Care Administration, program manuals, and Medicaid-related activities of the agency. Remain informed about the operations of the Medicaid Enrollment Broker, including plan enrollment and eligibility rules. Remain informed about the operations of the Medicaid fiscal agent and how changes impact the Enrollment Broker operations. Conduct an evaluation of contractor's management and operations reports for compliance. This relates to the contractor's performance in establishing and maintaining satisfactory production schedules, levels of production, efficient processing and office procedures. Participate in reviewing and monitoring assigned Medicaid Enrollment Broker Vendor operations, as comprehended by Agency policy and contract expectations for the purposes of providing to departmental management essential information to be used in managing enrollment broker performance within the context of the SMMC program. Perform research and resolution activities related to Enrollment Broker Medicaid Recipient enrollment processing to determine contract compliance. This includes, but is not limited to, research and report recipient related enrollment issues, document recipient related enrollment error trends and report to the Vendor Systems Monitoring team and assist with the monitoring or implementation of resolutions to assure proper functionality and contract compliance. Assist in the development, review and approval of vendor operational procedures to assure procedures comply with the contract and all amendments. Supports and participates in Enrollment Broker Quality Assurance monitoring. Periodic state travel in order to conduct program monitoring Performs other duties as assigned. This position will be hired at the non-negotiable base rate of $20 hourly. 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 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 accommodation.
Responsibilities
- maintaining up-to-date knowledge concerning the Florida Medicaid program, including pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State Plan, and Medicaid program manuals
- Conduct an evaluation of contractor's management and operations reports for compliance
- Participate in reviewing and monitoring assigned Medicaid Enrollment Broker Vendor operations
- Perform research and resolution activities related to Enrollment Broker Medicaid Recipient enrollment processing to determine contract compliance
- Assist in the development, review and approval of vendor operational procedures to assure procedures comply with the contract and all amendments
- Supports and participates in Enrollment Broker Quality Assurance monitoring
- Periodic state travel in order to conduct program monitoring
- 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)
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Career Level
Entry Level
Education Level
No Education Listed
