Regulatory Specialist

Select how often (in days) to receive an alert: Select how often (in days) to receive an alert: The State Personnel System is an E-Verify employer. For more information click on ourE-Verify Website . Requisition No:881713 Agency: Agency for Health Care Administration Working Title: 68020069 - REGULATORY SPECIALIST I 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 the 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: HIGH QUALITY Emphasizing quality in all that we do to improve health outcomes, always putting the individual first. TRANSPARENT Supporting initiatives that promote transparency and empower consumers in making well informed healthcare decisions. 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 a Regulatory Specialist 1 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 Services and serves as a primary point of contact for enrolled Medicaid recipients, and members of the community with questions and concerns about Medicaid. This is a professional position in the Fort Myers Medicaid Field Office, Bureau of Recipient Services within the Division of Medicaid, Agency for Health Care Administration (Agency). This Medicaid Field Office also houses the Medicaid Complaint Operations Center (MCOC) and Medicaid Fair Hearing Unit (MHU). The incumbent works under the direct supervision of the Field Office Manager and performs confidential administrative functions for the field office related to monthly expenditures, personnel activities, and inventory of equipment and supplies. This position is responsible for performing administrative functions necessary to ensure the field office remains in compliance with applicable human resource regulations, including the handling of confidential and sensitive personnel information. Serves as personnel liaison for the field office and works closely with the Agency's human resource department to answer personnel questions or issues raised by staff. Develops, updates and maintains local administrative files on all personnel including current position descriptions, mandatory training certificates, P-Card assignment, ID badges and parking passes. Works with appropriate staff to resolve any discrepancies. The incumbent maintains an inventory of supplies and equipment to ensure that staff have adequate resources to perform their job functions. Conducts a periodic review of existing inventory to confirm accuracy and identify any additional needs and/or discrepancies. The incumbent initiates office supply orders using My Florida Market Place or P-Card and obtains prior authorization from Field Office Manager prior to completing purchases. compiles ongoing budget information, The incumbent oversees general office operations related to maintenance of telephone and office equipment. Obtains bids and initiates lease or purchase agreements; coordinates all issues related to vendor and landlord issues; coordinates issues related to computer equipment or technology with the local IT Representative. The incumbent assists with tracking field-based activities such as provider application interviews and site visits, secret shopper activities, community outreach events, transportation meetings and social service forums. This includes updating related databases and preparing reports, as needed. The incumbent assists with redacting data in response to public records requests. The incumbent is responsible for reviewing data and preparing unit-specific reports related to Medicaid complaints/issues and Medicaid fair hearings. The incumbent ensures all critical clerical functions are covered and provides backup coverage when necessary, including but not limited to the following: sharing reception duties for the office, receiving, screening, and routing telephone calls, processing and distributing incoming and outgoing mail. The incumbent monitors the MCOC Task lnbox and the MCOC Public lnBox, in a backup capacity. The incumbent completes an assessment of new complaint submissions to confirm issues were entered into the complaint module correctly, per current protocols, and alerts their supervisor if/when errors are identified. Searches for and links any duplicate submissions and assigns complaints to appropriate staff within established timeframes. Alerts the MCOC Program Administrator of any issues/concerns regarding these submissions that prevent or delay assignment to staff. The incumbent maintains a log of expenditures and assists the Field Office Manager with review of the monthly expenditure report. Reviews the encumbrance reports to ensure that the numbers are accurate and that expenditures are within the Field Office budget allotment. Alerts the Field Office Manager if/when discrepancies are identified. Resolves any discrepancies with finance and accounting. Completes and submits reconciliation sheet to the Field Office Manager on a monthly basis. The incumbent coordinates travel arrangements for the Field Office Manager and other staff, as directed. Prepares travel reimbursement requests for the Field Office Manager and other staff. The incumbent coordinates request for P-Cards from staff that travel frequently and have a need to use rental cars and/or have overnight stays during travel. The incumbent in this position maintains up-to-date knowledge about the Florida Medicaid program by participating in Agency training opportunities and through self-education utilizing available resources, including but not limited to, the Agency's internal and external web sites, provider alerts, and RPA share point sites. The incumbent knows how to search for pertinent Federal laws and regulations, applicable state statutes and Medicaid rules, as needed. The incumbent remains informed about Agency projects and initiatives by participating in available webinars, staff meetings, and by subscribing to provider alerts. The incumbent remains knowledgeable about Statewide Medicaid Managed Care (SMMC) contract provisions and amendments, SMMC talking points and guidance statements, SMMC plan subcontractors and TPAs, and information shared via SMMC all-plan communications distributed by the Agency. The incumbent in this position shall assist with the annual records retention exercise to identify and process eligible documents, including preparation, routing and submission of records disposition documents. Performs other duties as assigned. This position is not a remote or telework position. Benefits of Working for the State of Florida: Working for the State of Florida is more than a paycheck. We offer an excellent array of benefits, including: Health insurance (i.e., individual and family coverage) to eligible employees Life insurance; $25,000 policy is free plus option to purchase additional life insurance Dental, vision and supplemental insurance State of Florida retirement options, including employer contributions Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida Ability to earn up to 104 hours of sick leave annually Nine paid holidays and 1 personal holiday each year Opportunities for career advancement Tuition waivers (accepted by major Florida Colleges/universities) Student loan forgiveness opportunities (eligibility required) Shared Savings Program for select medical services For more information about the Bureau of Medicaid Recipient and Provider Assistance, please visit our website at 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 Ability to communicate effectively, verbally and in writing. Ability to determine work priorities, assign work and ensure proper completion of work assignments within established timeframes. Ability to maintain composure and act in a professional manner when interacting with distressed and/or angry individuals. Ability to maintain strict confidentiality of all personnel, performance, disciplinary and related matters. Ability to solve problems and make decisions in a timely manner. Ability to work independently. Ability to travel with or without accommodation. Knowledge of structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. Skill in establishing and maintaining effective working relationships with others. Skill in knowing when there is a need for information; and identifying, locating, evaluating, and effectively using that information for the issue or question at hand. Skill in managing and organizing multiple work tasks simultaneously while maintaining a satisfactory work product and meeting all required deadlines. Skill in reviewing, correcting and synopsizing written grammar. Skill in understanding and applying applicable Medicaid rules, regulations, policies and procedures. Skill in utilizing different types of technologies to find/access information, including (but not limited to); basic Computer Software Programs, web-based resources and supporting tools. Skill in utilizing Microsoft Office Suite. Skill to accurately complete detailed forms, web-entries and documents, with no mistakes, typos or miscalculations. MINIMUM QUALIFICATIONS REQUIREMENTS Two years of professional experience in administrative work, professional regulation, consumer complaint program work, interviewing, business administration, customer or public relations, or investigations. Preferred Qualifications Moderate to extensive experience and abilities using different computer programs such as Excel, Outlook, and Word, etc., including quick and accurate typing/keyboarding skills. LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS N/A CONTACT: GERI FORTIN View phone number on click.appcast.io BACKGROUND SCREENING 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 Chapter435, F.S., and Chapter408, 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 View phone number on click.appcast.io). 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 Section112.0455, F.S., Drug-Free Workplace Act. VETERANS’ PREFERENCE. Pursuant to Chapter295, 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, DDForm 214 Member Copy#4) along with any other documentation as required by Rule55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here . All documentation is due by the close of the vacancy announcement. Location: FT MYERS, FL, US, 33901 Nearest Major Market: Fort Myers Nearest Secondary Market: Cape Coral For assistance, call the People First Service Center at View phone number on click.appcast.io Monday - Friday, 8:00 a.m. to 6:00 p.m., Eastern time. Pursuant to Florida Law, 110.211 F. S., the State of Florida is an EEO employer. #J-18808-Ljbffr