MEDICAID MANAGEMENT REVIEW MONITOR

Requisition No: 512462

Agency: Agency for Health Care Administration

Working Title: 68024191 - MEDICAID MANAGEMENT REVIEW MONITOR

Position Number: 68024191

Salary: $1,486.92- $3,152.54 Bi-Weekly

Posting Closing Date: 11/27/2021

This is an exciting opportunity to help shape the quality of health care in Florida. The Agency for Health Care Administration (AHCA) is the State of Florida agency responsible for oversight of the Medicaid program. 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.

We are seeking to hire a Medicaid Management Review Monitor who desires to work to enhance the delivery of health care services through the Florida Medicaid Program. This position requires a candidate who is

This position is located 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 monitoring assigned subsystems of the FMMIS. This includes the identification and analysis of management problems and the development of specific solutions using operations research, method analysis, critical path scheduling and other appropriate management techniques. Responsibilities also include claims and operational issue research involving the subsystems of the FMMIS and assisting the Recipient and Provider Assistance (RPA) Bureau with issues resolution.

AHCA offers an excellent array of benefits, including:

• Health insurance
• Life insurance
• Dental, vision and supplemental insurance
• Retirement benefits
• Vacation and sick leave
• Paid holidays
• Opportunities for career advancement
• Tuition waiver for public college courses
• Training opportunities

For more information about the Bureau of Medicaid Fiscal Agent Operations, please visit our website at http://ahca.myflorida.com/Medicaid/index.shtml.

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:

• General knowledge of the overall Medicaid program, Florida State Plan for Medicaid, Florida Administrative rules, and state and federal rules regarding Medicaid.
• Knowledge of the automated Florida Medicaid Management Information System (FMMIS) with detailed knowledge of the claims processing subsystem.
• General knowledge of the operational and fiscal procedures of the Medicaid fiscal agent related to claims processing.
• Ability to prepare reports and correspondence.
• Ability to plan, organize and coordinate work assignments.
• Ability to communicate effectively verbally and in writing.
• Ability to establish and maintain effective working relationships with others.
• Ability to develop program manuals, policies, procedures, standards, and rules

MINIMUM QUALIFICATIONS REQUIREMENTS:

• Four years of professional experience in systems analysis, management analysis, program planning, program research, program evaluation, engineering, or administrative work.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS: N/A

CONTACT : DEBBIE KELLEY 850-412-3449

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.

Nearest Major Market: Tallahassee