68020069 - REGULATORY SPECIALIST I

State of Florida•Fort Myers, FL

21h•$34,760 - $45,188•Onsite

About The Position

This is an exciting opportunity to help shape the quality of health care in Florida. We are seeking to hire a Regulatory Specialist 1 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 Services and serves as a primary point of contact for enrolled Medicaid recipients, and members of the community with questions and concerns about Medicaid. This is a professional position in the Fort Myers Medicaid Field Office, Bureau of Recipient Services within the Division of Medicaid, Agency for Health Care Administration (Agency). This Medicaid Field Office also houses the Medicaid Complaint Operations Center (MCOC) and Medicaid Fair Hearing Unit (MHU). The incumbent works under the direct supervision of the Field Office Manager and performs confidential administrative functions for the field office related to monthly expenditures, personnel activities, and inventory of equipment and supplies. This position is responsible for performing administrative functions necessary to ensure the field office remains in compliance with applicable human resource regulations, including the handling of confidential and sensitive personnel information. Serves as personnel liaison for the field office and works closely with the Agency's human resource department to answer personnel questions or issues raised by staff. Develops, updates and maintains local administrative files on all personnel including current position descriptions, mandatory training certificates, P-Card assignment, ID badges and parking passes. Works with appropriate staff to resolve any discrepancies. The incumbent maintains an inventory of supplies and equipment to ensure that staff have adequate resources to perform their job functions. Conducts a periodic review of existing inventory to confirm accuracy and identify any additional needs and/or discrepancies. The incumbent initiates office supply orders using My Florida Market Place or P-Card and obtains prior authorization from Field Office Manager prior to completing purchases. Compiles ongoing budget information. The incumbent oversees general office operations related to maintenance of telephone and office equipment. Obtains bids and initiates lease or purchase agreements; coordinates all issues related to vendor and landlord issues; coordinates issues related to computer equipment or technology with the local IT Representative. The incumbent assists with tracking field-based activities such as provider application interviews and site visits, secret shopper activities, community outreach events, transportation meetings and social service forums. This includes updating related databases and preparing reports, as needed. The incumbent assists with redacting data in response to public records requests. The incumbent is responsible for reviewing data and preparing unit-specific reports related to Medicaid complaints/issues and Medicaid fair hearings. The incumbent ensures all critical clerical functions are covered and provides backup coverage when necessary, including but not limited to the following: sharing reception duties for the office, receiving, screening, and routing telephone calls, processing and distributing incoming and outgoing mail. The incumbent monitors the MCOC Task Inbox and the MCOC Public Inbox, in a backup capacity. The incumbent completes an assessment of new complaint submissions to confirm issues were entered into the complaint module correctly, per current protocols, and alerts their supervisor if/when errors are identified. Searches for and links any duplicate submissions and assigns complaints to appropriate staff within established timeframes. Alerts the MCOC Program Administrator of any issues/concerns regarding these submissions that prevent or delay assignment to staff. The incumbent maintains a log of expenditures and assists the Field Office Manager with review of the monthly expenditure report. Reviews the encumbrance reports to ensure that the numbers are accurate and that expenditures are within the Field Office budget allotment. Alerts the Field Office Manager if/when discrepancies are identified. Resolves any discrepancies with finance and accounting. Completes and submits reconciliation sheet to the Field Office Manager on a monthly basis. The incumbent coordinates travel arrangements for the Field Office Manager and other staff, as directed. Prepares travel reimbursement requests for the Field Office Manager and other staff. The incumbent coordinates request for P-Cards from staff that travel frequently and have a need to use rental cars and/or have overnight stays during travel. The incumbent in this position maintains up-to-date knowledge about the Florida Medicaid program by participating in Agency training opportunities and through self-education utilizing available resources, including but not limited to, the Agency's internal and external web sites, provider alerts, and RPA share point sites. The incumbent knows how to search for pertinent Federal laws and regulations, applicable state statutes and Medicaid rules, as needed. The incumbent remains informed about Agency projects and initiatives by participating in available webinars, staff meetings, and by subscribing to provider alerts. The incumbent 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. The incumbent in this position shall assist with the annual records retention exercise to identify and process eligible documents, including preparation, routing and submission of records disposition documents. Performs other duties as assigned. This position is not a remote or telework position.

Requirements

Two years of professional experience in administrative work, professional regulation, consumer complaint program work, interviewing, business administration, customer or public relations, or investigations.
Ability to communicate effectively, verbally and in writing.
Ability to determine work priorities, assign work and ensure proper completion of work assignments within established timeframes.
Ability to maintain composure and act in a professional manner when interacting with distressed and/or angry individuals.
Ability to maintain strict confidentiality of all personnel, performance, disciplinary and related matters.
Ability to solve problems and make decisions in a timely manner.
Ability to work independently.
Ability to travel with or without accommodation.
Knowledge of structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
Skill in establishing and maintaining effective working relationships with others.
Skill in knowing when there is a need for information; and identifying, locating, evaluating, and effectively using that information for the issue or question at hand.
Skill in managing and organizing multiple work tasks simultaneously while maintaining a satisfactory work product and meeting all required deadlines.
Skill in reviewing, correcting and synopsizing written grammar.
Skill in understanding and applying applicable Medicaid rules, regulations, policies and procedures.
Skill in utilizing different types of technologies to find/access information, including (but not limited to); basic Computer Software Programs, web-based resources and supporting tools.
Skill in utilizing Microsoft Office Suite.
Skill to accurately complete detailed forms, web-entries and documents, with no mistakes, typos or miscalculations.

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.

Responsibilities

Performs confidential administrative functions for the field office related to monthly expenditures, personnel activities, and inventory of equipment and supplies.
Performs administrative functions necessary to ensure the field office remains in compliance with applicable human resource regulations, including the handling of confidential and sensitive personnel information.
Serves as personnel liaison for the field office and works closely with the Agency's human resource department to answer personnel questions or issues raised by staff.
Develops, updates and maintains local administrative files on all personnel including current position descriptions, mandatory training certificates, P-Card assignment, ID badges and parking passes.
Maintains an inventory of supplies and equipment to ensure that staff have adequate resources to perform their job functions.
Conducts a periodic review of existing inventory to confirm accuracy and identify any additional needs and/or discrepancies.
Initiates office supply orders using My Florida Market Place or P-Card and obtains prior authorization from Field Office Manager prior to completing purchases.
Compiles ongoing budget information.
Oversees general office operations related to maintenance of telephone and office equipment.
Obtains bids and initiates lease or purchase agreements; coordinates all issues related to vendor and landlord issues; coordinates issues related to computer equipment or technology with the local IT Representative.
Assists with tracking field-based activities such as provider application interviews and site visits, secret shopper activities, community outreach events, transportation meetings and social service forums.
Updates related databases and preparing reports, as needed.
Assists with redacting data in response to public records requests.
Reviews data and preparing unit-specific reports related to Medicaid complaints/issues and Medicaid fair hearings.
Ensures all critical clerical functions are covered and provides backup coverage when necessary, including but not limited to: sharing reception duties for the office, receiving, screening, and routing telephone calls, processing and distributing incoming and outgoing mail.
Monitors the MCOC Task Inbox and the MCOC Public Inbox, in a backup capacity.
Completes an assessment of new complaint submissions to confirm issues were entered into the complaint module correctly, per current protocols, and alerts their supervisor if/when errors are identified.
Searches for and links any duplicate submissions and assigns complaints to appropriate staff within established timeframes.
Alerts the MCOC Program Administrator of any issues/concerns regarding these submissions that prevent or delay assignment to staff.
Maintains a log of expenditures and assists the Field Office Manager with review of the monthly expenditure report.
Reviews the encumbrance reports to ensure that the numbers are accurate and that expenditures are within the Field Office budget allotment.
Alerts the Field Office Manager if/when discrepancies are identified.
Resolves any discrepancies with finance and accounting.
Completes and submits reconciliation sheet to the Field Office Manager on a monthly basis.
Coordinates travel arrangements for the Field Office Manager and other staff, as directed.
Prepares travel reimbursement requests for the Field Office Manager and other staff.
Coordinates request for P-Cards from staff that travel frequently and have a need to use rental cars and/or have overnight stays during travel.
Maintains up-to-date knowledge about the Florida Medicaid program by participating in Agency training opportunities and through self-education utilizing available resources, including but not limited to, the Agency's internal and external web sites, provider alerts, and RPA share point sites.
Knows how to search for pertinent Federal laws and regulations, applicable state statutes and Medicaid rules, as needed.
Remains informed about Agency projects and initiatives by participating in available webinars, staff meetings, and by subscribing to provider alerts.
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.
Assists with the annual records retention exercise to identify and process eligible documents, including preparation, routing and submission of records disposition documents.
Performs other duties as assigned.

Benefits

Health insurance (i.e., individual and family coverage) to eligible employees
Life insurance; $25,000 policy is free plus option to purchase additional life insurance
Dental, vision and supplemental insurance
State of Florida retirement options, including employer contributions
Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida
Ability to earn up to 104 hours of sick leave annually
Nine paid holidays and 1 personal holiday each year
Opportunities for career advancement
Tuition waivers (accepted by major Florida Colleges/universities)
Student loan forgiveness opportunities (eligibility required)
Training opportunities
Flexible Spending Accounts
Shared Savings Program for select medical services
Lower copays for prescription drugs
Health and Wellness discounts