Requisition No: 849968
Agency: Agency for Health Care Administration
Working Title: 68900305 - OPS MEDICAL/ HEALTH CARE PROGRAM ANALYST
Pay Plan: Temp
Position Number: 68900305
Salary: $19.69 Hourly
Posting Closing Date: 04/11/2025
Total Compensation Estimator Tool
Agency Overview:
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:

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 an OPS Medical/Health Care Program 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 located in the Bureau of Medicaid Recipient and Provider Assistance (RPA).
RPA serves as a primary point of contact for enrolled Medicaid providers, Medicaid recipients, and members of the community with questions and concerns about Medicaid.
This position is responsible for gathering, tracking, and analyzing operational performance data to improve operational productivity and efficiency.
The incumbent in this position must acquire and maintain knowledge about the Medicaid program in general, the functional responsibilities of all offices within the Bureau of Recipient and Provider Assistance, AHCA rules, regulations and procedures that affect bureau operations and performance, as well as the specific responsibilities and authority of the Bureau Chief.
Contract performance and compliance monitoring related to the system responsible for enrollment file processing in the preparation of reports, related presentations, and data query requests.
Conduct ongoing monitoring of contracts to ensure compliance with standards and conditions.
Manage and monitor daily files, for timeliness and accuracy.
Serve as the Agency’s Liaison between AHCA staff and other agencies for file issues or delays.
Perform technical assistance for system users, including but not limited to, system access, and technical training. Perform system monitoring and conduct recipient research for accuracy on enrollment, beneficiary and reject issues.
Knowledge of methods for compiling, organizing, and analyzing data. Knowledge of problem-solving techniques. Knowledge of and experience with word processing, spreadsheet, and/or database software. Ability to relate effectively to clients, providers, and staff of community agencies. Ability to plan, organize, and complete work assignments. Ability to establish and maintain effective working relationships. Ability to coordinate and prepare written and statistical reports.
Develop, review, analyze, and coordinate with agency requestor(s), the contractor’s CR time estimate and proposed action in response to CR requests to ensure an accurate understanding of the CR request.
Independently analyze CR test data created by the contractor before reviewing with the CR requester.
Review the CR test data with the CR author, answering questions concerning system logic that the requestor may have.
Ensure proper documentation is received and reviewed for accuracy and completeness if system documentation is required as a result of a CR request.
Respond to all assigned correspondence, inquiries, and complaints as it pertains to area of expertise.
Maintain up-to-date knowledge of managed care issues, remains informed about the Medicaid related activities of AHCA and about the operations of the Medicaid fiscal agent.
Contract performance and compliance monitoring related to the system responsible for Provider Network file processing, in the preparation of reports, related presentations and data query requests.
Provides technical assistance to health plans, accessing and navigating the system for submitting and processing Provider Network files, including but not limited to review of system functions for accuracy, conduct research on file processing, to assure accuracy of systems documentation and reports.
Perform other duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES

Knowledge of methods for compiling, organizing, and analyzing data.
Knowledge of problem-solving techniques.
Knowledge of and experience with word processing, spreadsheet, and/or database software.
Ability to relate effectively to clients, providers, and staff of community agencies.
Ability to plan, organize, and complete work assignments.
Ability to establish and maintain effective working relationships.
Ability to coordinate and prepare written and statistical reports.
Ability to communicate effectively, verbally and in writing.
Ability to travel with or without accommodation.

MINIMUM QUALIFICATIONS REQUIREMENTS

At least two years of experience in developing, evaluating and/or using data reports; for planning, workload analysis or monitoring purposes including two years of Microsoft Excel or similar software experience.
At least three years of experience explaining policies and procedures to customers with a limited understanding of the subject matter or researching and resolving customer issues and complaints.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

Please refer the Job description for details