State of Florida-posted 5 days ago
Entry Level
Onsite • Tallahassee, FL
1,001-5,000 employees

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 Program Finance (MPF).  MPF manages and projects Florida’s $34.4 billion Medicaid Services budget, oversees financial reporting of the Agency’s contracted Medicaid health plans, calculates both institutional and non-institutional Medicaid reimbursement rates, and disburses supplemental payments to Medicaid providers.   This position is responsible for assisting in the development, coordination, and implementation of the programs relating to Medicaid Hospital DPP, Indirect Medical Education (IME), and School District Administrative Claiming (SDAC). Prepare Hospital DPP, IME, and SDAC payment requests. Prepare "ad­hoc" reports from Public Records and Legislative requests. Produce Hospital DPP, IME, SDAC, and Threshold models for Legislative Planning. Also, coordinate with outside vendors and Centers for Medicare and Medicaid Services (CMS) on audit requests and annual reconciliations. Prepare and distribute Hospital DPP models and analyses of other supplemental payment programs that interact with the Hospital DPP program. Maintain current and archive versions of Hospital DPP, IME, and SDAC audits and analyses.   The incumbent is responsible for analyzing cost reports and audits of school district providers and making appropriate adjustments to determine allowable costs. Calculate reimbursements in accordance with Medicaid reimbursement plans and policies and applicable federal and state rules and regulations. Identify the need for and obtain additional information and cost data from providers to complete the process of establishing reimbursement rates. Establish district-specific rates for various Medicaid services. Prepare cost report computer documents for all school district providers. The incumbent in this position will act as the MPF team lead for school-based services and will coordinate with other Bureaus within the Agency to implement the Medicaid school-based services programs.   Interpret State and Federal statutes to determine provider eligibility for participation in supplemental payment programs. Coordinate data transfers between Florida managed care plans and the Agency for Health Care Administration for model development and program reconciliations.   Implement policies and procedures of the Agency, as well as the audit and program analysis functions within the section.   Maintains up-to-date knowledge concerning the Florida Medicaid Program, including pertinent statutes, Florida State Plan for Medicaid, Florida administrative rules and regulations, program manuals, and operations for the Budget & Supplemental Funding Unit. Review draft policy manuals and administrative rule changes and provide comments to appropriate units.   This position will be filled at a salary of $22.92 per hour and is non-negotiable.   This position will report to the Headquarters location in Tallahassee.   This position is not a remote or telework position.

  • Assist in the development, coordination, and implementation of the programs relating to Medicaid Hospital DPP, Indirect Medical Education (IME), and School District Administrative Claiming (SDAC).
  • Prepare Hospital DPP, IME, and SDAC payment requests.
  • Prepare "ad­hoc" reports from Public Records and Legislative requests.
  • Produce Hospital DPP, IME, SDAC, and Threshold models for Legislative Planning.
  • Coordinate with outside vendors and Centers for Medicare and Medicaid Services (CMS) on audit requests and annual reconciliations.
  • Prepare and distribute Hospital DPP models and analyses of other supplemental payment programs that interact with the Hospital DPP program.
  • Maintain current and archive versions of Hospital DPP, IME, and SDAC audits and analyses.
  • Analyze cost reports and audits of school district providers and making appropriate adjustments to determine allowable costs.
  • Calculate reimbursements in accordance with Medicaid reimbursement plans and policies and applicable federal and state rules and regulations.
  • Identify the need for and obtain additional information and cost data from providers to complete the process of establishing reimbursement rates.
  • Establish district-specific rates for various Medicaid services.
  • Prepare cost report computer documents for all school district providers.
  • Act as the MPF team lead for school-based services and will coordinate with other Bureaus within the Agency to implement the Medicaid school-based services programs.
  • Interpret State and Federal statutes to determine provider eligibility for participation in supplemental payment programs.
  • Coordinate data transfers between Florida managed care plans and the Agency for Health Care Administration for model development and program reconciliations.
  • Implement policies and procedures of the Agency, as well as the audit and program analysis functions within the section.
  • Maintains up-to-date knowledge concerning the Florida Medicaid Program, including pertinent statutes, Florida State Plan for Medicaid, Florida administrative rules and regulations, program manuals, and operations for the Budget & Supplemental Funding Unit.
  • Review draft policy manuals and administrative rule changes and provide comments to appropriate units.
  • Three years of experience using Microsoft Excel, including advanced skills and knowledge of Pivot Tables, V-Lookup, X-Lookup, IF statements, and formatting for publication/mail merge.
  • 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 methods.
  • 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 verbally and in writing.
  • Ability to establish and maintain effective working relationships with others.
  • Knowledge of macros.
  • Preference will be given to candidates who have a bachelor's degree from an accredited college or university in a relevant discipline such as mathematics, economics, or a related field.
  • 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)
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