68053420 - MEDICAL/HEALTH CARE PROGRAM ANALYST

Requisition No: 885889 Agency: Agency for Health Care Administration Working Title: 68053420 - MEDICAL/HEALTH CARE PROGRAM ANALYST Pay Plan: Career Service Position Number: 68053420 Salary: $1,833.39 - $2,383.41 Biweekly Posting Closing Date: 10/26/2026 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 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 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 in the Bureau of Medicaid Recipient Services (MRS). MRS serves as a primary point of contact for Medicaid recipients, and members of the community with questions and concerns about Medicaid. This position is responsible for researching and responding to Medicaid issues, concerns, and complaints, as well as providing technical assistance to help recipients and providers understand Medicaid coverage policy and assure that recipients receive proper care as set forth in State Statutes, rules, policies, and Code of Federal Regulations. The incumbent in this position serves as a team lead for the Complaint Operations Center and provides policy and procedural guidance to unit staff. The incumbent in this position shall maintain up-to-date knowledge concerning the Florida Medicaid program, including pertinent Federal laws and regulations, state statutes and rules, the Florida Medicaid State Plan and its amendment processes, Medicaid Managed Care Waivers and Medicaid program manuals. The incumbent in this position shall remain informed about the operations of the Medicaid fiscal agent, including Medicaid claims processing, billing procedures, reimbursement methodologies and provider enrollment. The incumbent in this position shall remain informed about Medicare and other federal and state health care related programs, including other state and national Medicaid-related research and demonstration projects, health care program innovations for special populations, and alternative financing and service delivery systems models. The incumbent shall maintain knowledge about the Medicaid State Plan, waivers, regulations, and processes. The incumbent in this position shall maintain up-to-date knowledge of current Statewide Medicaid Managed Care (SMMC) contract provisions and amendments, SMMC talking points and guidance statements, SMMC plan subcontractors and TPAs, and SMMC all-plan communications distributed by the Agency. The incumbent shall coordinate with Medicaid recipients, providers, policy staff, plan management staff, and SMMC plans as needed to research and resolve assigned Medicaid managed care issues and document their activities in the complaint module, per current protocols. The incumbent shall alert their immediate supervisor if/when plan responses are not received by due date, the plan’s actions appear to be non-compliant with specific contract provisions, and/or the information provided by the plan in response to any issue appears to be insufficient or inaccurate. The incumbent in this position shall receive, research, and respond to Legislative Assignments, CorrFlow, and other special assignments regarding questions, and priority issues on behalf of Medicaid recipients and providers. Contact constituent to obtain information. Research, resolve, and respond to issues, making appropriate referrals as needed. Ensure updates are provided to the legislative office and/or Agency headquarters on actions taken to resolve the issue. Maintain ongoing communication with constituents throughout the process. The incumbent shall provide Medicaid policy expertise to other unit staff regarding routine legislative assignments. The incumbent in this position shall support and assist with healthcare Facility Closures and/or Medicaid Terminations, as needed, including the following tasks: Assists with delivery of notices to facilities and residents, establishing telephone contact with family members/responsible parties and contact guardian where appropriate. Distributes "Family Information Kit” and works with identified Medicaid residents or appropriate legal representatives to secure alternative placement and provide appropriate counseling. Coordinates transportation to new facility verifying resident ID and transfer location. Provides on-site presence throughout the closure/termination process at the request of HQA. Maintains ongoing communication between HQA and Medicaid Field Office staff throughout closure event. The incumbent shall represent the Agency on government and community partnerships, community outreach events, Medicaid overview presentations, transportation boards, community alliances, interagency agreement teams, local planning groups, HIV planning councils and social services agency forums as assigned. The incumbent shall review complaints in a pending review status and conduct a random sampling of issues assigned to Complaint Operations Unit staff, as assigned, according to current protocols. Reports any deficiencies to the unit supervisor for staff correction and coaching. The incumbent acts as delegate for the Program Operations Administrator, as needed. 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) • Training opportunities • Flexible Spending Accounts • Shared Savings Program for select medical services • Lower copays for prescription drugs • Health and Wellness discounts For a more complete list of benefits, please visit For more information about the Bureau of Medicaid Recipient Services, 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 Knowledge of methods for compiling, organizing, and analyzing data. Knowledge of problem-solving techniques. 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 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. LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS N/A CONTACT:

CRYSTAL BRYSON 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 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 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 Section 112.0455, F.S., Drug-Free Workplace Act. VETERANS’ PREFERENCE.

Pursuant to Chapter 295, 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, DD Form 214 Member Copy #4) along with any other documentation as required by Rule 55A-7, Florida Administrative Code. Veterans’ Preference documentation requirements are available by clicking here. All documentation is due by the close of the vacancy announcement.