68065041 - Government Operations Cons Iii

Government Operations Consultant III

This is an exciting opportunity to help shape the quality of health care in Florida. We are seeking to hire a Government Operations Consultant III 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 Policy. Medicaid Policy is responsible for the development, coordination, and implementation of Florida Medicaid program policies, including: all Medicaid federal authorities (e.g. the Florida State Plan, 1115 waivers and home and community-based waivers), administrative rules, coverage policies, managed care plan contracts, bill analyses, drug utilization review boards, preferred drug lists, supplemental rebate contracts, and Kid Care/Title 21.

This position is responsible for researching, planning, developing, coordinating, implementing, evaluating, and maintaining policies under the Florida Medicaid program.

Research

• Maintain up-to-date knowledge concerning all aspects of the Florida Medicaid program, including federal regulations, state statutes, administrative rules, and the Florida Medicaid State Plan.
• Maintain up-to-date knowledge of health care and relevant industry trends that may have an impact on Florida Medicaid or may inform policy development activities.
• Remain informed about the operations of the Medicaid fiscal agent, including Medicaid claims process, billing procedures, reimbursement methodologies, encounter submissions, and provider enrollment.
• Remain informed about Medicare policies, national Medicaid-related research and demonstration projects, Medicaid medical assistance program innovations for general and special populations, and alternative financing and service delivery systems models.
• Conduct research on assigned topics, including, but not limited to: performing a review of peer-reviewed research articles, federal and state laws, other reliable sources of evidence, the Florida Medicaid State Plan, Agency communications, State Medicaid Director Letters, and vendor contracts.

Program Planning and Analysis

• Analyze health care/program related information (including alternative financing and reimbursement strategies) in order to determine the effect on the Florida Medicaid program and compliance with federal and state laws.
• Perform the analysis and development of programmatic and fiscal impact statements based on proposed federal/state program or policy changes.
• Consult with staff to determine areas of improvement.
• Prepare reports of research findings, including synthesizing complex and/or large amounts of information into a useful format and presentation.
• Develop legislative budget requests and program proposals.
• Develop grant proposals.
• Develop legislative reports, including collection of necessary data elements.
• Develop and implement program designs, projects, and/or plans in order to meet bureau goals/priorities.

Policy Development

• Develop and maintain program policies and procedures under the Florida Medicaid program to ensure that programs operate in accordance with the goals and objectives of the Agency, federal and state laws, rules, regulations, and guidelines.
• Develop policy language for: the Medicare-Medicaid Coordination Contracts report guide, contracts, and amendments;
  Dear Managed Care Plan letters, contract interpretations, policy transmittals, and provider alerts.
• Track and monitor the routing and approval of all policy documents to ensure timely completion and adherence to Agency established deadlines.

Communication

• Provide technical assistance to ensure consistency in service/program operation and conformity with goals and objectives of the Agency, federal and state laws, rules, regulations, and guidelines.
• Provide technical assistance regarding service/program policies and procedures.
• Provide consultation through the accurate presentation of data and other service/program information.
• Advise higher-level management areas of improvement and/or concern and provide possible solution, as applicable.
• Identif…