68064932 - GOVERNMENT OPERATIONS CONSULTANT III

Government Operations Consultant III

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 the 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
• TRANSPARENT
• COST-EFFECTIVE

Position Overview :

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 located in the Bureau of Medicaid Program Finance (MPF). MPF manages and projects Florida's $33.8 billion Medicaid Services budget, oversees financial reporting of the Agency's contracted Medicaid health plans, calculates both institutional and non-institutional Medicaid reimbursement rates, and disburses supplemental payments to Medicaid providers. This position is responsible for assisting in the development, coordination, and implementation of the programs relating to Medicaid Hospital DPP, DSH, and LIP programs. Prepare Hospital DPP, DSH, and LIP payment requests. Prepare "ad-hoc" reports from Public Records and Legislative requests. Produce Hospital DPP, DSH, LIP, and Threshold models for Legislative Planning. Also coordinate with outside vendors and CMS on audit requests and annual reconciliations. Prepare and distribute Hospital DPP models and analyses of other supplemental payment programs that interact with the Hospital DPP program. Maintain current and archive versions of Hospital DPP, DSH, and LIP audits and analyses. This position interprets State and Federal statutes to determine provider eligibility for participation in supplemental payment programs. Coordinate data transfers between Florida managed care plans and the Agency for Health Care Administration for model development and program reconciliations. The incumbent will act as agency contract manager for assigned Medicaid contracts, which shall include, but may not be limited to, the following functions : Maintain active agency contract manager certification; Adhere to established agency procurement policies and procedures; Participate in the competitive and non-competitive procurement and development of assigned contracts; Oversee the day-to-day administrative, programmatic, and financial operations of assigned contracts; Enforce performance of assigned contract terms and conditions; Perform contract monitoring of vendor performance at least annually; Maintain appropriate and up-to-date contract files; and serve as liaison with assigned vendor(s). The incumbent implements policies and procedures of the agency and the audit and program analysis functions within the section. The incumbent will cooperate with and assists state and federal auditors in the conduct of their examinations. This position is responsible of maintaining up-to-date knowledge concerning the Florida Medicaid Program, including pertinent statues, Florida State Plan for Medicaid, Florida administrative rules and regulations, program manuals and operations for the Supplemental Payments Unit. Reviews draft policy manuals, and administrative rule changes, provides comments to appropriate unit. The incumbent will provide technical assistance to the Supplemental Payments Unit. Perform other duties and ad hoc requests as assigned. This position is not a remote or telework position.

Benefits of Working for the State of Florida :

Knowledge, Skills, and Abilities :

Minimum Qualifications Requirements :

Background Screening :

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.

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.

Veterans' Preference. Pursuant to Chapter 295, Florida Statutes, candidates eligible for Veterans' Preference will receive preference in employment for Career Service vacancies and are encouraged to apply. Certain service members may be eligible to receive waivers for postsecondary educational requirements. Candidates claiming Veterans' Preference must attach supporting documentation with each submission that includes character of service (for example, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans' Preference documentation requirements are available by clicking here . All documentation is due by the close of the vacancy announcement.