Responsibilities
- This position is responsible for maintaining up-to-date knowledge concerning the Florida Medicaid program, including pertinent federal regulations, state statutes, administrative rules, Florida Medicaid State Plan, and Medicaid program manuals.
- Remain informed about regulations of the Agency for Health Care Administration, program manuals, and Medicaid-related activities of the agency.
- Remain informed about the operations of the Medicaid Enrollment Broker, including plan enrollment and eligibility rules.
- Remain informed about the operations of the Medicaid fiscal agent and how changes impact the Enrollment Broker operations.
- Conduct an evaluation of contractor's management and operations reports for compliance.
- Participate in reviewing and monitoring assigned Medicaid Enrollment Broker Vendor operations, as comprehended by Agency policy and contract expectations for the purposes of providing to departmental management essential information to be used in managing enrollment broker performance within the context of the SMMC program.
- Perform research and resolution activities related to Enrollment Broker Medicaid Recipient enrollment processing to determine contract compliance.
- Assist in the development, review and approval of vendor operational procedures to assure procedures comply with the contract and all amendments.
- Supports and participates in Enrollment Broker Quality Assurance monitoring.
- Periodic state travel in order to conduct program monitoring
- Performs other duties as assigned.
Requirements
- 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.
- 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.
Benefits
- No state income tax for residents of Florida;
- State Group Insurance coverage options (must meet eligibility requirements), including health, life, dental, vision, and other supplemental insurance options;
- Savings & Spending Accounts;
- 401 (a) FICA Alternative Plan administered through VALIC (tax deferred Retirement Savings Plan);
- Participation in the Florida Deferred Compensation Plan (457b)
Work Arrangement
On-site
Additional Information
- This position will be hired at the non-negotiable base rate of $20 hourly.
- This position is not a remote or telework position.
- 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.
- 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.
