68061380 - SENIOR MANAGEMENT ANALYST II - SES

State of Florida • Tallahassee, FL

18h • Onsite

About The Position

The Agency for Health Care Administration is Florida's chief health policy and planning entity. The Agency is responsible for administering the Florida Medicaid program, the licensure and regulation of nearly 50,000 health care facilities, and empowering consumers through health care transparency initiatives. Under the direction of the Agency's Secretary, the Agency is focused on advancing Governor DeSantis’ vision for Florida’s health care system to be the most cost-effective, transparent, and high-quality health care system in the nation. Agency Objectives: HIGH QUALITY - Emphasizing quality in all that we do to improve health outcomes, always putting the individual first. TRANSPARENT - Supporting initiatives that promote transparency and empower consumers in making well informed healthcare decisions. COST-EFFECTIVE - Leveraging Florida’s buying power in delivering high-quality care at the lowest cost to taxpayers. This position is not a remote worker (teleworker) position. This position is exempt under confidentiality in accordance with F.S. 110.205 (2)(W). This position is located in the Inspector General’s Office and as such performs duties that relate to collective bargaining and personnel issues. This position reports directly to the Chief of Investigations (COI) within the Agency for Health Care Administration (AHCA), Office of Inspector General (OIG). This position is designated as a sensitive position that often requires access to confidential information while carrying out job duties. All projects should be conducted in accordance with appropriate standards and policies, where applicable. The incumbent of this position may be required to travel on occasion.

Requirements

• Knowledge and skills necessary to utilize Microsoft Suite products (including proficient use of Word, Excel, and Outlook).
• Ability to conduct personal interviews of subjects, complainants, and witnesses; to analyze case records; and to synthesize diverse information.
• Experience planning, conducting, reporting, and defending (in a due process hearing) criminal investigations, internal investigations, corporate integrity investigations, or administrative investigations.
• Excellent organizational, writing, and multi-tasking skills and the ability to effectively communicate with other OIG staff and Department management and staff at all levels.

Nice To Haves

• A bachelor's degree or higher in Criminology, Criminal Justice, Law or other related subject matter from an accredited institution of higher learning.
• Experience working in an investigative capacity within an OIG, including familiarity of and experience with conducting investigative activity in accordance with section 20.055, F.S.; Principles and Standards for Offices of Inspectors General (Green Book) published by the Association of Inspectors General; CFA investigation standards; and/or other applicable professional investigative standards.
• A minimum of two (2) years of full-time experience detecting and investigating employee misconduct; fraud; waste; program abuse; mismanagement; malfeasance; violations of law, rule, or policy; or workplace discrimination.

Responsibilities

• Conducts investigations in accordance with the investigative duties and responsibilities specified in s. 20.055, F.S. (Agency Inspectors General) and s. 112.3187-112.31895, F.S. (Whistle-blower Act), in addition to following agency policies and procedures.
• Investigative activities will include logical steps necessary to prove or disprove allegations of alleged fraud, waste, or abuse in agency programs, and employee misconduct.
• Prepares thorough, complete, and accurate documentation of work performed. This includes taking accurate notes, preparing factual memorandums of interviews, chronologically documenting actions taken on the assignment, and preparing and updating an investigative plan.
• Maintains case files (electronic and hard copy) in a neat and orderly fashion and in accordance with procedures.
• Maintains the ability to interview and secure sworn statements from complainants, witnesses, and subjects of investigations, obtain and analyze documents and data, secure evidence in accordance with Chapter 90, F.S. (Florida Evidence Code).
• Prepares affidavits and investigative briefings.
• Prepares complete and comprehensive reports and summary reports consistent with the established standards of the office and the Principles and Standards for Offices of Inspectors General (Green Book).
• Reviews and is familiar with statutes pertaining to confidentiality requirements as they relate to Whistle-blower investigations, Health Insurance Portability Accountability Act HIPAA), and Protected Health Information (PHI).
• Evaluates impact of confidentiality requirements on Office of Inspector General operations.
• Independently plans, manages, and conducts investigations, inquiries, and management reviews as assigned by the Chief of Investigations to identify violations of statutes, administrative codes, policies, procedures, or contracts.
• Provides briefings and training to Agency managers, employees or industry partners to heighten awareness regarding acts of fraud and misconduct, describe Inspector General functions and roles, and encourage cooperation between the Agency and Inspector General personnel.
• Develops and maintains professional liaison relationship with local, state, and federal law enforcement, prosecutorial agencies, and industry partners.
• Promptly reports any suspicion of a potential violation of criminal law to the jurisdictional law enforcement agency and makes referrals to other industry partners as deemed appropriate.
• Coordinates such reports and referrals with the Chief of Investigations and Inspector General.
• Presents and provides briefings to law enforcement, prosecutorial agencies, and industry partners.
• Testifies, if called upon, to investigative findings in a criminal or civil court as well as in administrative or personnel hearings.
• Assists other bureaus, regulators, the Office of the Chief Inspector General, other agency Inspectors General, and local, state, and federal law enforcement agencies with investigative activities when approved or directed by the Chief of Investigations or Inspector General.
• Assists with the recommendation and implementation of policies, procedures, improved detection and investigation strategies, and preventative fraud and abuse measures.
• Develops, maintains, participates, and implements investigative standards related to accreditation activities.
• Assists in the administration of Accreditation process management.
• Maintains any training, continuing education, and certification requirements as established by the Agency or Inspector General.
• Performs other related duties and special projects 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 176 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: Associate degree