Requisition No: 823810 

Agency: Agency for Health Care Administration

Working Title: 68055433 - FINANCIAL SPECIALIST

 Pay Plan: Career Service

Position Number: 68055433 

Salary: $1,851.56 biweekly 

Posting Closing Date: 05/20/2024 

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 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. Current Agency initiatives include implementing Florida’s groundbreaking Canadian Prescription Drug Importation Program, overhauling Florida’s healthcare technological ecosystem, and increasing insight in the cost of health care services.

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 Financial Specialist 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 Program Finance (MPF). MPF manages and projects Florida’s $34.5 billion Medicaid Services budget, oversees financial reporting of the Agency’s contracted Medicaid health plans, calculates both institutional and non-institutional Medicaid reimbursement rates, and disburses supplemental payments to Medicaid providers.

This position is responsible for specialized professional auditing, rate setting, and is an analysis position in the Bureau of Medicaid Program Finance. The incumbent will be responsible for planning, developing, and implementing cost reimbursement analysis activities.

A person in this position will be responsible for assisting in the planning, developing and implementing of Medicaid reimbursement policies and procedures; assisting in the development and implementation of short- and long-range plans for the cost reimbursement analysis subsection; developing and implementing cost reimbursement informational and operational procedures and manuals; assisting in the planning, development, and implementation of procedures to audit data submitted by applicants for license to operate nursing homes and determine if applicants are adequately financed to operate the facility; auditing provider cost reports and establishing provider reimbursement rates; developing procedures to evaluate requests from providers for increases in reimbursement rates to determine if an increase should be granted. The objectives of these activities are to develop and implement a Medicaid reimbursement program which ensures providers that rates established will be in compliance with Medicaid policies and reimbursement plans; to develop, seek funding of, and implement provider reimbursement methodologies which assure the provider fair and reasonable compensation for services rendered while also assuring that optimal results are obtained from public funds; to develop cost reimbursement methodologies which result in a positive approach to health care cost containment.

Set facility rates in accordance with Medicaid reimbursement plans, policies, and applicable federal and state rules and regulations. Coordinate all the activities necessary for the semi-annual (or annual, if mandated) rate settings for all nursing home providers enrolled in the Medicaid program. Update facility rates as audit and licensure results are made available. Review and analyze requests from Medicaid providers for rate adjustments and determine if a rate increase should be authorized. Calculate and set rates for the settlement of Medicaid interim reimbursement rates when the initial cost report becomes available. Verify that all rate changes are made correctly by the fiscal agent and retro-active payments, or adjustments are made appropriately by the fiscal agent for all rates in which the analyst is responsible.

Provide technical assistance and consultation to departmental staff, provider association, and other organizations and interested persons regarding policies and procedures for provider rate setting; assist in the preparation of informational and educational material on Medicaid provider rate setting; assist in the development and implementation of cost reimbursement rate setting training programs. Assist in processing Nursing Homes Changes of Ownership and creating new providers in rate calculation system, as well as responding to requests for liabilities and overpayments from other units within the Agency.

Assist in planning, developing, and implementing policies and procedures for provider rate setting and rate analysis. Assist in developing rate setting manuals as appropriate for the application of cost reimbursement plans and principles of reimbursement. Assist in planning for and coordinating the implementation of rate setting policies and procedures with other staff in the Bureau of Medicaid Program Finance, the Bureau of Medicaid Contract Management. the fiscal agent contractor, and other departmental offices and districts. Prepare forms and instructions for use by applicants, providers, and provider associations; assist in identifying and resolving any problems in the implementation of rate setting policy and procedure revisions. Review and analyze revisions to CMS Pub. 15-1, federal rules and regulations, and other related materials to determine their impact on rate setting policies and procedures.

Assist in identifying the need for and obtain additional information and cost data from providers to set a facilities initial rate. Assist in preparing special reports and analyses on provider costs and the fiscal effect of the primary features of the nursing home cost reimbursement plan including the payment mechanism, rates, grouping criteria, caps, cost projections, inflation allowances, cost allocation, rate revision frequency, geographic differentials, rate appeals, cost reports, allowable costs, depreciation, quality of care incentives, and profit allowances. Perform complex statistical and financial analyses of Medicaid provider costs in long term care and acute care facilities to assess their impact on overall Medicaid costs and for use in future Medicaid cost reimbursement planning. Assist in the development and compilation of various special management or provider cost comparisons from cost report data.

Maintain up-to-date knowledge concerning the Florida Medicaid program including pertinent statutes, Florida rules, regulations of the Department of Health and Human Services, provider manuals, and Medicaid billing procedures. Remain informed about Medicaid activities within the Agency for Health Care Administration and about operations of the fiscal agent contractor. Maintain detailed knowledge of Medicaid financial and statistical information at both state and national levels. Maintain detailed knowledge of Medicare and other health care program cost reimbursement principles and the Medicaid cost reimbursement and rate setting methods of other states. Remain informed about health care cost containment issues on the local, state, and national level. Maintain detailed knowledge of accepted accounting and auditing principles, procedures, and techniques.

Assist in the development of long-range plans for policy and procedures development, implementation and monitoring of cost reimbursement rate setting, and analysis activities. Assist in the development of plans and schedules for the review and analysis of the rate setting and analysis function, provider cost report monitoring, special projects, surveys and studies, and provider and staff training. Assist in developing plans for short term cost reimbursement analysis activities including policy revision, analysis of cost report data, provider reimbursement issues, and other areas. Assist in the development of analysis goals, objectives, and priorities. Assist in the development of performance standards and criteria in order to measure the accomplishment of goals and objectives.

Review and analyze cost reports in order to determine common errors and provider difficulty in using cost report forms. Assist in the development of revisions to the cost report forms based on these analyses. Assist in the development and implementation of cost report forms that are designed for data entry; assist in the development and implementation of automated provider cost systems. Assist in the development and implementation of revised rate setting policies and procedures designed to increase the efficiency of the rate setting and analysis functions.

Perform other duties and responsibilities as required.

This position is being hired at the base rate of $1,851.56 biweekly/non-negotiable.

This position is not a remote or telework position; it will have to report to a Field Office or the Headquarters in Tallahassee.

Benefits of Working for the State of Florida:

Working for the State of Florida is more than a paycheck. The State’s total compensation package for employees features a highly competitive set of employee benefits including:

• State Group Insurance Coverage Options, including health, life, dental, vision, and other supplemental insurance options;

• Flexible Spending Accounts;

• State of Florida retirement options, including employer contributions;

• Generous annual and sick leave benefits;

• 9 paid holidays a year and 1 Personal Holiday each year;

• Career advancement opportunities;

• Tuition waiver for courses offered by Florida’s nationally ranked State University System ;

• Training and professional development opportunities;

• And more!

For more information about the Bureau of Medicaid Program Finance, please visit our website at http://ahca.myflorida.com/Medicaid/index.shtml.

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 accounting principles and procedures.

Knowledge of the principles and techniques of effective written and verbal communications.

Knowledge of basic mathematics and economics.

Knowledge of financial forecasting techniques.

Intermediate knowledge of Excel, Outlook, and Microsoft Word.

Ability to use a calculator and a computer terminal.

Ability to adequately document work assignments completed.

Ability to prepare audit reports.

Ability to conduct research and investigations.

Ability to review, analyze and evaluate financial and operational data.

Ability to audit financial forecasted statements.

Ability to compile statistical data.

Ability to understand and apply laws, rules, regulations, policies, and procedures.

Ability to process and respond to consumer complaints.

Ability to verify the accuracy of numerical data.

Ability to plan, organize and coordinate work assignments.

Ability to communicate effectively verbally and in writing.

Ability to establish and maintain effective working relationships with others.

Ability to prepare financial statements.

Ability to utilize problem solving techniques.

MINIMUM QUALIFICATIONS REQUIREMENTS

-At least two years’ experience with Microsoft Excel, Word, and Outlook.

-At least two years of work experience with processing, examining, analyzing, or interpreting accounting records or investigative financial information.

-A Bachelor’s degree from an accredited college or university in accounting, finance, mathematics, or economics, is preferred. Experience can substitute on a year-to-year basis for education.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT: KATHERINE GHENT (850) 412-4089

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.

The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer, and does not tolerate discrimination or violence in the workplace.

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.

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.