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68900198 - OPS HUMAN SERVICES ANALYST

68900198 - OPS HUMAN SERVICES ANALYST

People First Service CenterTallahassee, FL, United States
4 days ago
Job type
  • Permanent
Job description

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The State Personnel System is an E-Verify employer. For more information click on ourE-Verify Website .

Requisition No : 864684

Agency : Agency for Health Care Administration

Working Title : 68900198 - OPS HUMAN SERVICES ANALYST

The Agency for Health Care Administration (AHCA) 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 Agency Secretary, AHCA 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.

The Medicaid program provides low-income families and individuals with access to health care.

If you have a desire to use your talent and skills at an organization that provides critical services to millions of individuals and families across the state, AHCA invites you to apply to become an essential member of our team.

As one of Florida’s leading state agencies, AHCA’s diverse workforce community of more than 1,400 employees is proud of its efforts to serve the people of Florida.

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.

Position Overview

This is an exciting opportunity to help shape the quality of health care in Florida.

We are seeking to hire OPS-HUMAN SERVICES ANALYST 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 in the Bureau of Medicaid Fiscal Agent Operations (MFAO). MFAO serves as the primary organizational unit within the Agency to provide oversight and monitoring of the Agency’s Medicaid fiscal agent; responsible for the processing of Florida Medicaid claims and multiple supporting systems; ensuring Medicaid providers are properly enrolled into the program, Medicaid recipients receive proper coverage, enrollment into managed care plans; extracting, analyzing, and / or reporting Medicaid data; and ensuring that new Agency systems are planned and procured.

This position is responsible for performing highly technical and analytical work in the Bureau of Fiscal Agent Operations. It is related to the contract with the Medicaid fiscal agent, the Medicaid program of the state of Florida, FMMIS (the Florida Medicaid Management Information System) and FLORIDA, the Department of Children and Families (DCF) eligibility system.

Working as a team member with the Medicaid Management Review Monitor and Government Operations Consultant, the OPS Human Services Analyst is responsible for monitoring components of the recipient subsystem. This includes the identification and analysis of recipient file problems and the development of specific solutions using operations research, method analysis, and other appropriate management techniques.

The position works directly with DCF eligibility staff, providers, and recipients as necessary to resolve recipient file and eligibility issues.

Responsibilities

  • Inspect and evaluate transactions, records and reports related to the recipient file.
  • This includes monitoring and reviewing processes related to recipient subsystem of the FMMIS.
  • It includes all processes related to handling of inputs to the FMMIS and outputs from the FMMIS.
  • Monitor the receipt of recipient eligibility subsystem reports.
  • Work with DCF on analysis, identification, and correction of errors.
  • Provide technical assistance to DCF district office and area Medicaid staff with respect to the recipient file and file corrections.
  • This position is not a remote or telework position.

    A good attendance record is essential for any individual in this position as the work involved occurs daily and is time sensitive.

    The individual in this position is expected to report to work daily and on time.

    Leave must be requested in advance except in emergency circumstances not under the control of the employee.

    This position will be filled at $18.00 Hourly and is non-negotiable.

    Benefits of Working for the State of Florida

  • 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;
  • 401 (a) FICA Alternative Plan administered through VALIC (tax‑deferred Retirement Savings Plan);
  • Participation in the Florida Deferred Compensation Plan (457b)
  • What is OPS employment?

    OPS employment is a temporary employer / employee relationship used for accomplishing short term or intermittent tasks. OPS employees are at-will employees and are subject to actions such as pay changes, changes to work assignments, and terminations at the discretion of the Agency head or designee.

    OPS employees do not serve probationary periods or become permanent in their positions because they serve at the pleasure of the Agency head.

    Knowledge, Skills, And Abilities

  • Knowledge of methods for compiling, organizing, and analyzing data.
  • Knowledge and skill in operating Microsoft personal computer products, including Outlook email.
  • Knowledge of FMMIS Recipient File and FLORIDA systems.
  • Knowledge of Medicaid policy / procedures and Children & Families procedures relating to Medicaid.
  • Ability to review files, transactions and reports for completeness and compliance with existing policies, procedures, and regulations.
  • Knowledge of Social Security Administration procedures relating to Medicaid.
  • Ability to plan, organize, and coordinate work assignments.
  • Ability to communicate effectively.
  • Ability to establish and maintain effective working relationships with others.
  • Minimum Qualifications Requirements

  • Two (2) years of experience analyzing data.
  • Two (2) years of professional work experience in auditing, investigating or monitoring a program or service.
  • Licensure, Certification, Or Registration Requirements

    N / A

    Contact

    Carissa Baxter 850-412-3440

    Background Screening

    The State of Florida is an Equal Opportunity Employer / Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

    Candidates requiring a reasonable accommodation, as defined by the Americans with Disabilities Act, must notify the agency hiring authority and / or People First Service Center (1-866-663-4735). Notification to the hiring authority must be made in advance to allow sufficient time to provide the accommodation.

    The State of Florida supports a Drug-Free workplace. All employees are subject to reasonable suspicion drug testing in accordance with Section 112.0455, F.S., Drug-Free Workplace Act.

    For assistance, call the People First Service Center at (877) 562-7287 Monday - Friday, 8 : 00 a.m. to 6 : 00 p.m., Eastern time

    It is the policy of the Florida Agency for Health Care Administration that any applicant being considered for employment must successfully complete a State and National criminal history check as a condition of employment before beginning employment, and, if applicable, also be screened in accordance with the requirements of Chapter 435, F.S., and Chapter 408, F.S. No applicant may begin employment until the background screening results are received, reviewed for any disqualifying offenses, and approved by the Agency. Background screening shall include, but not be limited to, fingerprinting for State and Federal criminal records checks through the Florida Department of Law Enforcement (FDLE) and Federal Bureau of Investigation (FBI) and may include local criminal history checks through local law enforcement agencies.

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