Job Description

Requisition No: 869395

Agency: Agency for Health Care Administration

Working Title: 68900227 - OPS SR HUMAN SERVICE PROGRAM SPEC

Pay Plan: Temp

Position Number: 68900227

Salary: $17.53 - $18.00 Hourly

Posting Closing Date: 02/13/2026

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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.

This is a full-time OPS position, with regularly scheduled hours of Monday-Friday 8:00 a.m. to 5 p.m.

This OPS Senior Human Services Program Specialist position is anticipated to be filled at a rate of $17.53 - $18.00 per hour, based on the selected candidate's qualifications and experience.

This position may involve travel-related activities from 1-15%.

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

The Florida Medicaid program is one the top 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 most 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 healthcare providers suspected of engaging in fraudulent or abusive behavior, as well as overpayment recoveries, administrative sanctions, and the referral of suspected fraud or other criminal activities for law enforcement investigation.

The Sanctions & Enforcement Unit is a fast-paced unit within MPI that works collaboratively with internal and external partners to ensure fair, consistent, and defensible enforcement of program requirements.

The unit plays a key role in program integrity efforts by reviewing audit findings, analyzing information, evaluating compliance with, and applying applicable state and federal laws, rules, and policies to recommend and impose sanctions against Medicaid providers.

Staff prepare and issue sanction notices, and manage cases through the sanction process, including actions that proceed through the final order stage.

This OPS position provides support to the sanctions process by assisting with case tracking, quality review, and documentation management.

The role involves monitoring statutory timelines, including required notice periods, ensuring case files and supporting documentation are accurately maintained in the case tracking system, and assisting with the preparation and quality review of sanction notices and final orders.

The role also includes gathering documents and information from internal systems and online sources and assisting with investigative activities related to sanctions, including the preparation of investigative summaries or reports.

Attention to detail, organization, and the ability to manage multiple tasks are critical to supporting timely and legally sound sanction actions.

MPI provides a multitude of training opportunities for all MPI employees to enhance their professional growth.

For more information, please visit MPI at: http://ahca.myflorida.com/MCHQ/MPI/index.shtml

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 Other Personal Services (OPS) employees features a highly competitive set of employee benefits including:

• No state income tax for residents of Florida;

• State Group Insurance coverage options (must meet eligibility requirements), including health, life, dental, vision, and other supplemental insurance options;

• Savings & Spending Accounts;

• 401 (a) FICA Alternative Plan administered through VALIC (tax deferred Retirement Savings Plan);

• Participation in the Florida Deferred Compensation Plan (457b)

For a more complete list of benefits and eligibility requirements, visit www.mybenefits.myflorida.com.

What is OPS employment?

OPS employment is a temporary employer/employee relationship used for accomplishing short term or intermittent tasks. OPS employees are at-will employees and are subject to actions such as pay changes, changes to work assignment, and terminations at the pleasure of the agency head or designee.

OPS employees do not serve probationary periods or become permanent in their positions because they serve at the pleasure of the agency head.

KNOWLEDGE, SKILLS, AND ABILITIES

Knowledge of understanding office procedures, records management, and documentation standards.

Ability to organize, track, and maintain multiple case files while meeting required deadlines and timelines.

Ability to follow established procedures and apply rules, policies, and guidance accurately.

Awareness of confidentiality requirements and the importance of safeguarding sensitive information.

Skill in using computer applications such as case tracking systems, databases, word processing, and spreadsheets.

Skill in written communication sufficient to prepare summaries, reports and documentation for review.

Ability to work collaboratively with team members and communicate effectively with supervisors.

Knowledge of research methods and information gathering from internal systems and online sources.

Knowledge of Microsoft features including Word, Excel, and Outlook.

Skill in reviewing documents for accuracy, completeness, and consistency.

Ability to monitor statutory or required timelines and flag issues or discrepancies.

Ability to travel with or without accommodations.

MINIMUM QUALIFICATIONS REQUIREMENTS

•One year of professional or nonprofessional experience in a role involving research, records review, compliance, investigations, audits, casework, or analytical work.

•Preferences may be given to candidates who have completed coursework toward, or obtained, an associate’s degree or higher from an accredited college or university.

•Preference will be given to candidates with professional certifications related to compliance, auditing, research, data analysis, or program support functions.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

N/A

CONTACT: HELEN GUNN 850-412-4626

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.