68900149 - OPS REGULATORY ANALYST III

State of Florida • Tallahassee, FL

3d • $20 - $25 • 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 Regulatory Analyst III 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 $34.5 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
• Evaluating financial reports submitted by Health Plans contracted under the Statewide Medicaid Managed Care (SMMC) Program. These include, but are not limited to: NAIC Financial Statements, Achieved Savings Rebate (ASR) Reports, Annual Audit reports performed by an independent CPA firm, and Medical Loss Ratio (MLR) Summary Reports.
• Tracking and analyzing expenditure patterns and utilization trends, reviewing financial performance against established metrics, and preparing reports for internal review.
• Detecting issues or concerns within financial reports and collaborating with internal leadership and Health Plan financial staff to investigate and resolve discrepancies.
• Completing special analysis requests by providing projections, trend analysis, and identification of deviations. Presenting findings using charts, tables, slides, and other graphic formats.
• Conducting research and presenting data in the form of research papers, position reports, or publications.
• Verifying accuracy and completeness of work products and submitted documents.
• Communicating and liaising with other divisions, bureaus, and units within the Agency to provide routine financial information and fulfill data requests.
• Participating in scheduled and ad-hoc meetings related to Health Plan financial performance and reporting needs.
• Performing additional tasks as assigned.

This position will report to the Home Office in Tallahassee.

This position is not a remote or telework position.

Requirements

• Knowledge of statutory and GAAP accounting principles and procedures.
• Knowledge of the methods of compiling and analyzing data.
• Knowledge of monitoring techniques.
• Proficiency in Microsoft Excel, Word, Office, and PowerPoint.
• Ability to investigate, review, analyze, and evaluate data.
• Ability to examine financial records.
• Ability to understand and apply laws, rules, regulations, policies, and procedures.
• Ability to conduct research and prepare reports.
• Ability to probe and obtain critical facts.
• Ability to recognize the validity, authenticity, and propriety of accounting and operating records.
• Ability to learn new systems.
• Four years of experience in finance, accounting, contract management (including scope of work development, vendor management, accounting, budgeting, reporting, etc.), or other related fields.
• Three years of experience using Microsoft Office Suite (Excel, Word, Outlook).
• Must successfully complete training in contract management and become a certified contract manager within six months of hire in accordance with section 287.057(15)(c), F.S.

Nice To Haves

• Preference will be given to candidates who have a bachelor’s degree or higher from an accredited college or university in a relevant discipline such as finance, accounting, contract management, or another related field.

Responsibilities

• Evaluating financial reports submitted by Health Plans contracted under the Statewide Medicaid Managed Care (SMMC) Program. These include, but are not limited to: NAIC Financial Statements, Achieved Savings Rebate (ASR) Reports, Annual Audit reports performed by an independent CPA firm, and Medical Loss Ratio (MLR) Summary Reports.
• Tracking and analyzing expenditure patterns and utilization trends, reviewing financial performance against established metrics, and preparing reports for internal review.
• Detecting issues or concerns within financial reports and collaborating with internal leadership and Health Plan financial staff to investigate and resolve discrepancies.
• Completing special analysis requests by providing projections, trend analysis, and identification of deviations. Presenting findings using charts, tables, slides, and other graphic formats.
• Conducting research and presenting data in the form of research papers, position reports, or publications.
• Verifying accuracy and completeness of work products and submitted documents.
• Communicating and liaising with other divisions, bureaus, and units within the Agency to provide routine financial information and fulfill data requests.
• Participating in scheduled and ad-hoc meetings related to Health Plan financial performance and reporting needs.
• Performing additional tasks 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