68900246 - OPS RESEARCH ASSISTANT

State of Florida • Tallahassee, FL

8d • $15 - $16 • Onsite

About The Position

This is a full-time OPS position, with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5:00 p.m. This OPS Research Assistant position will be filled at a rate of $15.00 - $16.00 per hour based on the candidate's experience. This position does not require travel. The Agency requires background and fingerprint screening as a condition of employment.

The Florida Medicaid program is one of the five largest in the country and has an estimated $38 billion annual budget. Each month Florida Medicaid covers medical services for almost 4 million recipients. To most effectively serve this large patient population, one of the Agency goals is to ensure fewer budgeted dollars are lost to fraud, abuse, and waste. The Bureau of Medicaid Program Integrity (MPI) does this specifically through audits and investigations of healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive behavior, as well as overpayment recoveries, administrative sanctions, and the referral of suspected fraud or other criminal violations for law enforcement investigation.

Medicaid Program Integrity is a fast-paced bureau that addresses abusive behavior in the Florida Medicaid program to fight fraud, abuse, and waste. To do this, the highly collaborative and innovative units rely on a team with diverse educational and experience backgrounds.

The selected candidate will be responsible for various level of administrative activities to support the Managed Care Unit's operations that include daily office management, special projects, reporting, electronic documentation distribution both incoming and outgoing, documentation tracking, and other major office functions. The selected candidate will primarily gather, prepare, record, and archive secure/confidential correspondence in a timely manner to meet required deadlines. This position will be privy to sensitive information, and the candidate is expected to maintain information in the strictest confidence.

The selected candidate will be responsible for providing oversight of the Medicaid Health Plan's (MCPs) compliance with program integrity requirements set forth in state and federal law, as well as the provisions of contract and Medicaid policies. The candidate is responsible for the factual intake, review and reconciliation of the MCPs reports and submissions. In addition, receiving and forwarding documents to the appropriate staff member in a timely manner.

The selected candidate will be responsible for maintaining all files, electronic and otherwise, in a logical, orderly, and complete manner. The candidate is responsible for ensuring the history and documentation for all reporting and submission assignments are appropriately maintained on a current basis in the proper MPI tracking systems.

The selected candidate will also be responsible for working collaboratively with other MPI operational units participating in special projects, and monitoring and tracking the associated project/case statuses.

Requirements

• Two years of customer service experience.
• Knowledge of principles and techniques of research and analysis.
• Knowledge of Microsoft Word, Excel, PowerPoint, Outlook, Internet Explorer, SharePoint, and Adobe Acrobat.
• Ability to work independently.
• Ability to collect and organize data into logical format for presentation in reports, documents, spreadsheets, and other written materials.
• Ability to conduct fact-finding research.
• Ability to utilize problem-solving techniques.
• Ability to understand and apply applicable rules, regulations, policies and procedures relating to research and analysis.
• Ability to plan, organize, and coordinate work assignments.
• Ability to multi-task in a quick and efficient manner.
• Ability to communicate effectively.
• Ability to establish and maintain effective working relationships with others.

Nice To Haves

• High school diploma or its equivalent.

Responsibilities

• Gather, prepare, record, and archive secure/confidential correspondence in a timely manner to meet required deadlines.
• Provide oversight of the Medicaid Health Plan's (MCPs) compliance with program integrity requirements set forth in state and federal law, as well as the provisions of contract and Medicaid policies.
• Perform factual intake, review and reconciliation of the MCPs reports and submissions.
• Receive and forward documents to the appropriate staff member in a timely manner.
• Maintain all files, electronic and otherwise, in a logical, orderly, and complete manner.
• Ensure the history and documentation for all reporting and submission assignments are appropriately maintained on a current basis in the proper MPI tracking systems.
• Work collaboratively with other MPI operational units participating in special projects.
• Monitor and track associated project/case statuses.
• Perform various level of administrative activities to support the Managed Care Unit's operations that include daily office management, special projects, reporting, electronic documentation distribution both incoming and outgoing, documentation tracking, and other major office functions.

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

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED