68063485 - PROGRAM ADMINISTRATOR - SES

Requisition No: 846941 

Agency: Agency for Health Care Administration

Working Title: 68063485 - PROGRAM ADMINISTRATOR - SES

 Pay Plan: SES

Position Number: 68063485 

Salary:  $2,245.19 biweekly 

Posting Closing Date: 02/28/2025 

Total Compensation Estimator Tool

This is a full-time Selected Exempt Service (SES) management position, with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5 p.m.  This Program Administrator-SES position is anticipated to be filled at a rate of $2,245.19 bi-weekly/non-negotiable.  This position may involve travel-related activities from 1-25%.  Successful completion of a criminal background investigation is a condition of employment.

 

The Florida Medicaid program is one of the five largest in the country with an estimated $35 billion annual budget.  Each month Florida Medicaid covers medical services for over 5 million recipients.  To effectively serve this large patient population, one of the Agency goals is to ensure fewer budgeted dollars are lost to fraud, abuse, and waste.  The Bureau of Medicaid Program Integrity (MPI) does this specifically through audits and investigations of Medicaid providers, including managed care plans.  MPI also imposes administrative sanctions for program violations and refers suspected fraud or other criminal violations to appropriate law enforcement agencies for further investigation.

 

MPI operates with dynamic and fast-paced units that work closely together to serve the overall bureau mission.  MPI units are responsible for developing novel methods and innovative solutions necessary to address the complexity and scope of fraudulent and abusive behavior in the Florida Medicaid program.  These highly collaborative units rely on teams with diverse educational and experience backgrounds.

 

The selected candidate will be responsible for the effective management of team members in the bureau’s Managed Care Unit.  This supervisor is responsible for recruiting, hiring, and evaluating the performance of program staff, as well as motivating, training, planning, and directing employees’ work assignments.  This will include communication, motivation, team building, training and evaluating employees; planning, and coordinating the work initiatives of staff to ensure the timely and efficient performance of assigned duties. 

 

The selected candidate will be responsible for the effective operational management, maintenance, oversight, and compliance with program integrity requirements set forth in state and federal law, along with the provisions of contracts and Medicaid policies as it relates to the operation of the Statewide Medicaid Managed Care plan.  This position is responsible for conducting investigations of possible fraud, waste, or abuse and advising Administrators of appropriate protocols and possible actions.  The confidentiality of investigations and recommendations require knowledge of Florida and Federal Medicaid policy and guidelines along with health plan's regulations and activities. 

 

The incumbent will participate and lead preliminary investigations and inquiries using research and analytical skills utilizing available platforms while working closely with data analysis personnel.  Audits of managed care plans are a vital part of this position and the investigative and communicative skills necessary are crucial to the success of MPI's fraud prevention efforts. 

The selected candidate will work collaboratively with all MPI units to include analysts, managers, administrators as well as Managed Care Plan personnel in executing the mission of the Managed Care Unit, MPI and AHCA. 

     

Benefits of Working for the State of Florida:

Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including:

 

     •      State Group Insurance Coverage Options, including health, life, dental, vision, and other  supplemental insurance options;

     •      Flexible Spending Accounts;