Government Operations Consultant III
This is an exciting opportunity to help shape the quality of health care in Florida. We are seeking to hire a Government Operations Consultant III 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 Policy. Medicaid Policy is responsible for the development, coordination, and implementation of Florida Medicaid program policies, including : all Medicaid federal authorities (e.g. the Florida State Plan, 1115 waivers and home and community based waivers), administrative rules, coverage policies, managed care plan contracts, bill analyses, drug utilization review boards, preferred drug lists, supplemental rebate contracts, and KidCare / Title 21.
This position is responsible for researching, planning, developing, coordinating, implementing, evaluating, and maintaining policies under the Florida Medicaid program. Duties include :
Policy Development
The incumbent shall :
- Develop and maintain program policies and procedures under the Florida Medicaid / CHIP program to ensure that programs operate in accordance with the goals and objectives of the Agency, federal and state laws, rules, regulations, and guidelines.
- Develop policy language for : the Medicaid / CHIP report guides, contracts, and amendments; Dear Managed Care Plan letters, contract interpretations, policy transmittals, and provider alerts.
- Track and monitor the routing and approval of all policy documents to ensure timely completion and adherence to Agency established deadlines.
Research
The incumbent shall :
Maintain up-to-date knowledge concerning all aspects of the Florida Medicaid / CHIP program, including federal regulations, state statutes, administrative rules, and the Florida Medicaid State Plan / CHIP State Plan.Maintain up-to-date knowledge of health care and relevant industry trends that may have an impact on Florida Medicaid / Florida CHIP or may inform policy development activities.Remain informed about the operations of the Medicaid fiscal agent, including Medicaid claims process, billing procedures, reimbursement methodologies, encounter submissions, and provider enrollment.Remain informed about Medicare policies, national Medicaid / CHIP-related research and demonstration projects, Medicaid / CHIP medical assistance program innovations for general and special populations, and alternative financing and service delivery systems models.Conduct research on assigned topics, including, but not limited to : performing a review of peer-reviewed research articles, federal and state laws, other reliable sources of evidence, the Florida Medicaid / CHIP State Plan, Agency communications, State Medicaid Director Letters, and vendor contracts.Program Planning and Analysis
The incumbent shall :
Analyze health care / program related information (including alternative financing and reimbursement strategies) in order to determine the effect on the Florida Medicaid / CHIP program and compliance with federal and state lawsPerform the analysis and development of programmatic and fiscal impact statements based on proposed federal / state program or policy changes.Consult with staff to determine areas of improvement.Prepare reports of research findings, including synthesizing complex and / or large amounts of information into a useful format and presentation.Develop legislative budget requests and program proposals.Develop grant proposals.Develop legislative reports, including collection of necessary data elements.Develop and implement program designs, projects, and / or plans in order to meet bureau goals / priorities.Communication
The incumbent shall :
Provide technical assistance to ensure consistency in service / program operation and conformity with goals and objectives of the Agency, federal and state laws, rules, regulations, and guidelines.Provide technical assistance regarding service / program policies and procedures.Provide consultation through accurate presentation of data and other service / program information.Advise higher-level management areas of improvement and / or concern and provide possible solution, as applicable.Identify and document training needs.Prepare presentations materials, as assigned.Develop, coordinate, and implement statewide program training plans.Design, prepare, and evaluate training programs and materials.Conduct statewide and local training courses, as required.Participate on behalf of the Agency in local, state or national meetings, conferences, workshops, and seminars related to the Florida Medicaid / CHIP program.Contract Management
The incumbent shall :
Perform contract management activities in accordance with goals and objectives of the Agency and state and federal laws, rules, regulations, and guidelines.Develop and execute provider contracts addressing standard contract documents, services to be provided, manner of service provision, method of payment, and special provisions.Process, inspect, review, and approve deliverables, and invoices for payment.Track and monitor provider expenditures.Maintain appropriate contract files and records.Carry out other necessary contract management activities.This position is not a remote or teleworking position.
Benefits of working for the State of Florida :
Health insurance (i.e., individual and family coverage) to eligible employeesLife insurance; $25,000 policy is free plus option to purchase additional life insuranceDental, vision and supplemental insuranceState of Florida retirement options, including employer contributionsAbility to earn up to 104 hours of paid annual leave as a new employee with the State of FloridaAbility to earn up to 104 hours of sick leave annuallyNine paid holidays and 1 personal holiday each yearOpportunities for career advancementTuition waivers (accepted by major Florida Colleges / universities)Student loan forgiveness opportunities (eligibility required)Training opportunitiesFlexible Spending AccountsShared Savings Program for select medical servicesLower copays for prescription drugsHealth and Wellness discountsFor a more complete list of benefits, please visit https : / / www.mybenefits.myflorida.com / .
Join us at the Agency for Health Care Administration in fulfilling our mission to provide "Better Health Care for all Floridians."
Knowledge, Skills, and Abilities
Knowledge of basic management principles and practices.
Knowledge of the methods of data collection and analysis.
Ability to coordinate a consultative program designed to ensure the resolution of managerial and operational problems.
Ability to determine work priorities and ensure proper completion of work assignments.
Ability to communicate effectively.
Ability to establish and maintain effective working relationships with others.
Ability to assess budgetary needs.
Ability to formulate policies and procedures.
Ability to understand and apply applicable rules, regulations, policies and procedures relating to operational and management analysis activities.
Ability to organize data into logical format for presentation in reports, documents and other written materials.
Ability to collect, evaluate and analyze data to develop alternative recommendations, solve problems, document work and other activities relating to the improvement of operational and management practices.
Ability to conduct fact finding research.
Ability to work independently.
Ability to solve problems and make decisions.
Ability to travel with or without accommodations.
Minimum Qualifications Requirements
Two years of experience developing health care related policies.
Two years of technical writing experience.
Two years of experience managing complex assignments.
This position requires that you obtain a Florida Certified Contract Manager certification within six months of hire.
Preference will be given to applicants that have a bachelor's degree from an accredited college or university.
Note : The selection process may include a writing sample.
Licensure, Certification, or Registration Requirements
N / A
Contact : Suzi Kemp (850) 412 - 3887