State of Florida
MEDICAL/HEALTH CARE PROG ANALYST - SES - 64055877
State of Florida, Tallahassee, Florida, us, 32318
Overview
MEDICAL/HEALTH CARE PROG ANALYST - SES - 64055877 at State of Florida. This position is within the Florida Department of Health, Division of Disease Control, HIV/Section, and reports to the Patient Care Director. The posting indicates duties involving supervision, program management, insurance coordination for ADAP clients, and adherence to program goals and policies. Responsibilities
This position spends most of the time engaged in supervisory responsibilities, including communicating with, motivating, training, and evaluating employees, planning and directing work, and making personnel decisions (hire, transfer, suspend, lay off, recall, promote, discharge, assign, reward, or discipline). Develops performance expectations, conducts regular performance discussions, completes performance reviews, maintains vacation and work schedules, ensures proper coverage, and completes timesheets. Oversees coordination of insurance benefits for ADAP clients to maximize access, quality, and customer service; collaborates with the Patient Care Director and other offices to align operations, planning, and program goals. Supervises direct reports, including motivating, training, providing guidance, and directing staff; develops expectations and conducts performance reviews and disciplinary actions if needed; maintains schedules and ensures coverage; ensures staff training requirements are met. Leads implementation of the program by assisting with planning, development, and implementation of ADAP in line with the state’s Integrated HIV Prevention and Care Plan; focuses on data analysis, data distribution, and data utilization. Develops and maintains written office procedures, including process maps, for all functions related to insurance coordination; ensures cross-training of staff. Oversees contract management for ADAP insurance, including contract development, processing and payment of invoices, contract monitoring, and allocation of funds; ensures compliance with contract deliverables and department standards (e.g., Pharmacy Benefits Management and premium payments). Reviews insurance policies and prescription benefits to ensure a cost-effective approach to maintaining coverage for ADAP clients within program guidelines. Oversees the pursuit of excess premium tax credits for clients with qualified health plans; manages tracking, reporting, and billing for pharmaceutical rebates and refunds due to premium or claim adjustments. Develops and implements training materials for ADAP staff and communicates with ADAP clients and stakeholders; ensures consistency with program policy and procedures. Participates in budget planning, grant proposals, and periodic reports; analyzes program performance, identifies trends, gaps, and opportunities for improvement; provides regular reports to leadership and HRSA. Supports ADAP quality improvement activities, including data coordination for on-site visits, delivering technical assistance, tracking follow-ups, and implementing corrective actions as required. Monitors client surveys and feedback to continuously improve the insurance program and serves as the first point of contact for client grievances regarding insurance services. Performs other duties as assigned. Required Knowledge, Skills, and Abilities
Ability to make decisions and solve problems. Knowledge of developing objectives and strategies. Strong listening, social perceptiveness, time management, multi-tasking, critical thinking, and identification of downstream consequences. Ability to communicate with persons outside the organization. Ability to analyze data or information. Ability to monitor and control resources; implement ideas or initiatives; guide, direct, and motivate subordinates; team development; updating job-relevant knowledge; familiarity with law, government, and jurisprudence; customer and personal service. Qualifications
Minimum: Six years’ experience managing insurance benefits and insurance coordination in a healthcare setting. Preferred: BS in Healthcare Administration, Public Health, or related field. Work Location
Tallahassee, FL Benefits and Compliance
The State of Florida provides a comprehensive total compensation package; for details, see the official benefits information. This position requires a security background check and/or drug screening and participation in direct deposit. Applicants must be able to read, write, and communicate effectively in English. The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer and does not tolerate discrimination or violence in the workplace. Reasonable accommodations under the Americans with Disabilities Act can be requested.
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MEDICAL/HEALTH CARE PROG ANALYST - SES - 64055877 at State of Florida. This position is within the Florida Department of Health, Division of Disease Control, HIV/Section, and reports to the Patient Care Director. The posting indicates duties involving supervision, program management, insurance coordination for ADAP clients, and adherence to program goals and policies. Responsibilities
This position spends most of the time engaged in supervisory responsibilities, including communicating with, motivating, training, and evaluating employees, planning and directing work, and making personnel decisions (hire, transfer, suspend, lay off, recall, promote, discharge, assign, reward, or discipline). Develops performance expectations, conducts regular performance discussions, completes performance reviews, maintains vacation and work schedules, ensures proper coverage, and completes timesheets. Oversees coordination of insurance benefits for ADAP clients to maximize access, quality, and customer service; collaborates with the Patient Care Director and other offices to align operations, planning, and program goals. Supervises direct reports, including motivating, training, providing guidance, and directing staff; develops expectations and conducts performance reviews and disciplinary actions if needed; maintains schedules and ensures coverage; ensures staff training requirements are met. Leads implementation of the program by assisting with planning, development, and implementation of ADAP in line with the state’s Integrated HIV Prevention and Care Plan; focuses on data analysis, data distribution, and data utilization. Develops and maintains written office procedures, including process maps, for all functions related to insurance coordination; ensures cross-training of staff. Oversees contract management for ADAP insurance, including contract development, processing and payment of invoices, contract monitoring, and allocation of funds; ensures compliance with contract deliverables and department standards (e.g., Pharmacy Benefits Management and premium payments). Reviews insurance policies and prescription benefits to ensure a cost-effective approach to maintaining coverage for ADAP clients within program guidelines. Oversees the pursuit of excess premium tax credits for clients with qualified health plans; manages tracking, reporting, and billing for pharmaceutical rebates and refunds due to premium or claim adjustments. Develops and implements training materials for ADAP staff and communicates with ADAP clients and stakeholders; ensures consistency with program policy and procedures. Participates in budget planning, grant proposals, and periodic reports; analyzes program performance, identifies trends, gaps, and opportunities for improvement; provides regular reports to leadership and HRSA. Supports ADAP quality improvement activities, including data coordination for on-site visits, delivering technical assistance, tracking follow-ups, and implementing corrective actions as required. Monitors client surveys and feedback to continuously improve the insurance program and serves as the first point of contact for client grievances regarding insurance services. Performs other duties as assigned. Required Knowledge, Skills, and Abilities
Ability to make decisions and solve problems. Knowledge of developing objectives and strategies. Strong listening, social perceptiveness, time management, multi-tasking, critical thinking, and identification of downstream consequences. Ability to communicate with persons outside the organization. Ability to analyze data or information. Ability to monitor and control resources; implement ideas or initiatives; guide, direct, and motivate subordinates; team development; updating job-relevant knowledge; familiarity with law, government, and jurisprudence; customer and personal service. Qualifications
Minimum: Six years’ experience managing insurance benefits and insurance coordination in a healthcare setting. Preferred: BS in Healthcare Administration, Public Health, or related field. Work Location
Tallahassee, FL Benefits and Compliance
The State of Florida provides a comprehensive total compensation package; for details, see the official benefits information. This position requires a security background check and/or drug screening and participation in direct deposit. Applicants must be able to read, write, and communicate effectively in English. The State of Florida is an Equal Opportunity Employer/Affirmative Action Employer and does not tolerate discrimination or violence in the workplace. Reasonable accommodations under the Americans with Disabilities Act can be requested.
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