68064375 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST

Requisition No: 838780 

Agency: Agency for Health Care Administration

Working Title: 68064375 - SENIOR HUMAN SERVICES PROGRAM SPECIALIST

 Pay Plan: Career Service

Position Number: 68064375 

Salary:  $1,598.52 biweekly 

Posting Closing Date: 10/17/2024 

Total Compensation Estimator Tool

Agency Overview:

The Agency for Health Care Administration 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.

 

Position Overview:

This is a full-time career service position, with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5 p.m.  The Senior Human Services Program Specialist is to be filled at a rate of $1,598.52 bi-weekly/non-negotiable.  This position may involve travel related activities from 1-15%.  The Agency requires background and fingerprint screening as a condition of employment.

 

The Florida Medicaid program is one of the five largest in the country and has an estimated $35 billion annual budget. Each month Florida Medicaid covers medical services for almost 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 healthcare providers, including managed care plans, suspected of engaging in fraudulent or abusive behavior, as well as overpayment recoveries, administrative sanctions, and the referral of suspected fraud or other criminal violations for law enforcement investigation.

 

The Senior Human Services Program Specialist position will support the fraud and abuse prevention efforts within the Bureau of Medicaid Program Integrity.  The position incorporates all the functions that fall within the Bureaus' responsibility and works with the various units in MPI.  The incumbent will be responsible for the coordination of program activities while supporting the operations of unit and bureau administrative activities and is expected to work both independently and in a group setting to complete work assignments related to bureau needs.  This position will be privy to sensitive information and the incumbent is expected to maintain information in the strictest confidence. 

 

The work involves a range of advanced level administrative and operational activities to support the protocols in place specific to MPI's mission of preventing fraud and abuse in the Florida Medicaid system.  The selected candidate will assist the Assistant Chief and Program Administrator in the planning, development, and implementation of a comprehensive fraud and abuse effort related to Medicaid in our state.  This position conducts and assists in investigations and audits with the responsibility of maintaining and tracking case files.  The incumbent will be responsible for participating in identifying and processing actions against providers to include sanctions, fines, suspensions, and terminations.  A solid knowledge of the Florida Medicaid system is critical for this position.

 

The position is also responsible for coordination of meetings, trainings, projects, bureau record retention and maintaining bureau files consistent with the State of Florida, AHCA, and bureau protocols.  Excellent organizational, administrative, and communicative skills are key, as this position coordinates and collaborates with the entire bureau, Health Quality Assurance division, Agency personnel, as well as Medicaid providers.  Effective research and analytical skills are vital in this position.

 

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;