68063482 - Inspector Specialist

Position: 68063482 - INSPECTOR SPECIALIST
Requisition No: 881158

Agency:
Agency for Health Care Administration

Working Title:

- INSPECTOR SPECIALIST

Pay Plan:
Career Service

Position Number:

Salary: $1,881.39 Biweekly

Posting Closing Date: 08/19/2026

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 which are typically Monday-Friday 8:00 a.m. to 5 p.m.

This position has a Competitive Area Differential (CAD) and will be hired at $1,833.39 + $48.00 = $1,881.39 biweekly/non-negotiable.

This position may involve travel-related activities from 1-25%.

The Agency requires background and fingerprint screening as a condition of employment.

A good attendance record is essential for any individual in this position as the work involved occurs daily and is time sensitive.

The individual in this position is expected to report to work daily and on time.

All applicants selected for interview will be required to perform a skills test that consist of proficient English reading and writing comprehension and an understanding about legal proceedings and investigations related to health care fraud and abuse.

The Florida Medicaid program is one of the five largest in the country and has an estimated $38 billion annual budget.

Each month Florida Medicaid covers medical services for almost 4 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 health care providers, including managed care plans, suspected of engaging in fraudulent or abusive behavior, as well as through over payment recoveries, administrative sanctions, and referrals of suspected fraud or other criminal violations to law enforcement for investigation.

MPI operates with dynamic and fast-paced units that work closely together to serve the overall mission of the Bureau.

A candidate selected for a position with an investigative unit will be responsible for conducting investigations, visiting providers, identifying over payments, writing investigative summary reports, and making recommendations for referrals to other entities involving Medicaid providers in accordance with state and federal rules, laws, and statutes.

The selected candidate will be expected to prepare, lead, and conduct pre-audit preparations, prepayment reviews, and project initiatives following the unit's approved protocols.

The candidate should have experience in conducting interviews as well as investigations or other similar professional experience such as compliance monitoring or auditing sufficient to demonstrate the capability of analysis of Medicaid providers (billing information as well as other investigative findings) to determine violations of Medicaid policies and laws.

The selected candidate will be required to collaborate with other MPI operational units and regulatory agencies as well as to participate in joint data driven field initiatives.

The incumbent is responsible for conducting on-site visits to determine violations of Medicaid policies and is responsible for ensuring consistency and support regarding specific Prevention and Program Oversight (Field Operations) protocols.

This position requires a broad array of knowledge and experience specifically related to fraud prevention programs, compliance assessment, legal analysis, and report writing in the investigative and audit process as well as a desire to innovate.

The selected candidate will assist in conducting investigations related to fraud, abuse, and waste through research and analysis of complex health and business-related data.

Included in the functions of this position are activities such as:

* Utilizing open-source and proprietary resources to conduct the investigations and related administrative actions, as well as monitoring and tracking the associated case status.

* Preparing referrals to law enforcement entities.

* Identifying, analyzing, and interpreting trends or patterns in data sets, as well as other investigative and research tools.

* Collaborating with team members on projects and assignments.

* Conducting payment restriction reviews in accordance with state and federal rules, laws, and statutes.

This position has been identified as mission essential.

The incumbent in this position may be required to work during the weekend or on holidays.

In addition, mission essential personnel will be required to work during disasters, to include but not limited to, work before, during and/or beyond normal work hours or days in the event of an emergency.

Emergency work may involve the…