68064375 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST

State of Florida • Tallahassee, FL

3d • Hybrid

About The Position

This is a full-time career service position with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5 p.m. The Senior Human Services Program Specialist position is to be filled at a rate of $1,636.98 bi-weekly and is non-negotiable. This position may involve travel-related activities from 1-15%. The Agency requires background and fingerprint screening as a condition of employment. The Florida Medicaid program is one of the five largest in the nation, with an estimated $38 billion annual budget serving nearly five million recipients. The Bureau of Medicaid Program Integrity (MPI) protects the integrity of the Florida Medicaid program by identifying fraud, abuse, and noncompliance through provider oversight, investigations, administrative sanctions, and coordination with state and federal partners. The Senior Human Services Program Specialist serves within the Bureau's Sanctions and Enforcement Unit and performs professional investigative, analytical, and regulatory work supporting administrative enforcement actions involving Florida Medicaid providers. Working under the direction of management, the incumbent conducts administrative investigations, reviews and evaluates documentary evidence, researches applicable laws, rules, and policies, and prepares investigative summaries and recommendations supporting administrative sanctions. The incumbent is responsible for preparing and processing administrative legal documents, including notices of intent, suspension notices, termination notices, payment restriction notices, proposed final orders, final orders, and other investigative correspondence. The position ensures investigative files and enforcement actions are complete, accurate, and legally sufficient while maintaining the highest level of confidentiality. This position works closely with Bureau leadership, Agency attorneys, investigators, Provider Enrollment, and other Agency staff throughout the investigative and sanctions process. The incumbent participates in weekly Bureau and Agency meetings to provide updates regarding provider sanctions, enforcement activities, and facility actions while assisting with the coordination and tracking of cases from initiation through final disposition. The incumbent performs investigative research, analyzes provider records and supporting documentation, identifies potential violations of Medicaid laws and rules, prepares written recommendations, and assists in developing appropriate administrative enforcement actions. As knowledge and experience are gained, the incumbent will progressively assume greater responsibility in managing investigative assignments and administrative sanctions. Strong analytical, organizational, research, written communication, and critical thinking skills are essential. The successful candidate must exercise sound judgment, maintain strict confidentiality, and effectively manage multiple priorities in a fast-paced regulatory environment.

Requirements

• One year of professional or nonprofessional experience in a role involving research, records review, compliance, investigations, audits, casework, or analytical work.
• Proficiency with Microsoft Word, Excel, Outlook, PowerPoint, SharePoint, and other computer applications.
• Ability to travel with or without accommodation.

Nice To Haves

• Completed coursework toward, or obtained, an associate’s degree or higher from an accredited college or university.
• Professional certifications related to compliance, auditing, research, data analysis, or program support functions.

Responsibilities

• Conducts administrative investigations.
• Reviews and evaluates documentary evidence.
• Researches applicable laws, rules, and policies.
• Prepares investigative summaries and recommendations supporting administrative sanctions.
• Prepares and processes administrative legal documents, including notices of intent, suspension notices, termination notices, payment restriction notices, proposed final orders, final orders, and other investigative correspondence.
• Ensures investigative files and enforcement actions are complete, accurate, and legally sufficient while maintaining the highest level of confidentiality.
• Participates in weekly Bureau and Agency meetings to provide updates regarding provider sanctions, enforcement activities, and facility actions.
• Assists with the coordination and tracking of cases from initiation through final disposition.
• Performs investigative research.
• Analyzes provider records and supporting documentation.
• Identifies potential violations of Medicaid laws and rules.
• Prepares written recommendations.
• Assists in developing appropriate administrative enforcement actions.
• Progressively assumes greater responsibility in managing investigative assignments and administrative sanctions as knowledge and experience are gained.

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

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed